KITE- Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.
Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada.
Exp Gerontol. 2021 Jan;143:111170. doi: 10.1016/j.exger.2020.111170. Epub 2020 Nov 23.
Measures of gait center of pressure (COP) can be recorded using simple available technologies in clinical settings and thus can be used to characterize gait quality in older adults and its relationship to falls. The aim of this systematic review was to investigate the association between measures of gait COP and aging and falls. A comprehensive search of electronic databases including MEDLINE, Embase, Cochrane Central Register of Controlled Trials, CINAHL (EBSCO), Ageline (EBSCO) and Scopus was performed. The initial search yielded 2809 papers. After removing duplicates and applying study inclusion/exclusion criteria, 34 papers were included in the review. Gait COP has been examined during three tasks: normal walking, gait initiation, and obstacle negotiation. The majority of studies examined mean COP position and velocity as outcome measures. Overall, gait in older adults was characterized by more medial COP trajectory in normal walking and lower average anterior-posterior and medio-lateral COP displacements and velocity in both gait initiation and obstacle crossing. Moreover, findings suggest that Tai chi training can enhance older adults' balance control during gait initiation as demonstrated by greater COP backward, medial and forward shift in all three phases of gait initiation. These findings should be interpreted cautiously due to inadequacy of evidence as well as methodological limitations of the studies such as small sample size, limited numbers of 'fallers', lack of a control group, and lack of interpretation of COP outcomes with respect to fall risk. COP measures can be adopted to assess fall-related gait changes in older adults but more complex measures of COP that reveal the dynamic nature of COP behavior in step-to-step variations are needed to adequately characterize gait changes in older adults.
步压中心（COP）的测量可以使用临床环境中简单的现有技术进行记录，因此可用于描述老年人的步态质量及其与跌倒的关系。本系统评价的目的是调查 COP 测量值与衰老和跌倒之间的关系。对包括 MEDLINE、Embase、Cochrane 对照试验中心注册库、CINAHL（EBSCO）、Ageline（EBSCO）和 Scopus 在内的电子数据库进行了全面检索。初步搜索产生了 2809 篇论文。在去除重复项并应用研究纳入/排除标准后，有 34 篇论文被纳入综述。COP 步态在三个任务中进行了检查：正常行走、步态启动和障碍物穿越。大多数研究将 COP 位置和速度的平均值作为结果指标进行了检查。总体而言，老年人的步态表现为正常行走时 COP 轨迹更偏向内侧，步态启动和障碍物穿越时前后向和左右向 COP 位移和速度平均值较低。此外，研究结果表明，太极拳训练可以增强老年人在步态启动时的平衡控制能力，表现为步态启动三个阶段的 COP 向后、向内侧和向前移动幅度更大。这些发现应该谨慎解释，因为证据不足以及研究方法上的限制，如样本量小、“跌倒者”人数有限、缺乏对照组以及未能根据跌倒风险对 COP 结果进行解释。COP 测量可以用于评估老年人与跌倒相关的步态变化，但需要更复杂的 COP 测量方法来揭示 COP 行为在逐步变化中的动态性质，以充分描述老年人的步态变化。
