Geriatric Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark.
BMC Geriatr. 2022 Jul 25;22(1):615. doi: 10.1186/s12877-022-03271-5.
To review the validated instruments that assess gait, balance, and functional mobility to predict falls in older adults across different settings.
Umbrella review of narrative- and systematic reviews with or without meta-analyses of all study types. Reviews that focused on older adults in any settings and included validated instruments assessing gait, balance, and functional mobility were included. Medical and allied health professional databases (MEDLINE, PsychINFO, Embase, and Cochrane) were searched from inception to April 2022. Two reviewers undertook title, abstract, and full text screening independently. Review quality was assessed through the Risk of Bias Assessment Tool for Systematic Reviews (ROBIS). Data extraction was completed in duplicate using a standardised spreadsheet and a narrative synthesis presented for each assessment tool.
Among 2736 articles initially identified, 31 reviews were included; 11 were meta-analyses. Reviews were primarily of low quality, thus at high risk of potential bias. The most frequently reported assessments were: Timed Up and Go, Berg Balance Scale, gait speed, dual task assessments, single leg stance, functional Reach Test, tandem gait and stance and the chair stand test. Findings on the predictive ability of these tests were inconsistent across the reviews.
In conclusion, we found that no single gait, balance or functional mobility assessment in isolation can be used to predict fall risk in older adults with high certainty. Moderate evidence suggests gait speed can be useful in predicting falls and might be included as part of a comprehensive evaluation for older adults.
综述评估步态、平衡和功能性移动能力以预测不同环境下老年人跌倒的已验证工具。
对所有研究类型的叙述性和系统评价进行伞式综述，无论是否进行荟萃分析。综述重点关注任何环境中的老年人，并纳入评估步态、平衡和功能性移动能力的已验证工具。从开始到 2022 年 4 月，检索医学和联合健康专业数据库（MEDLINE、PsychINFO、Embase 和 Cochrane）。两名审查员独立进行标题、摘要和全文筛选。通过系统评价偏倚风险评估工具（ROBIS）评估综述质量。使用标准化电子表格重复进行数据提取，并针对每个评估工具进行叙述性综合呈现。
在最初确定的 2736 篇文章中，有 31 篇综述被纳入；其中 11 篇为荟萃分析。综述的质量主要较低，因此存在潜在偏倚的高风险。报告最频繁的评估包括：计时起立行走测试、伯格平衡量表、步态速度、双重任务评估、单腿站立、功能性伸展测试、串联步态和站立以及椅子站立测试。这些测试的预测能力的研究结果在不同综述中不一致。
总之，我们发现没有单一的步态、平衡或功能性移动能力评估可以单独用于预测老年人的跌倒风险，这一点是确定无疑的。有中等证据表明，步态速度可以用于预测跌倒，并且可能作为老年人综合评估的一部分。
