Voorn Paul Benjamin, Oomen Remco, Buczny Jacek, Bossen Daniël, Visser Bart, Pijnappels Mirjam
Faculty of Health, Sport and Physical Activity, Centre of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, Netherlands.
Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
Eur Rev Aging Phys Act. 2025 Apr 1;22(1):4. doi: 10.1186/s11556-025-00370-1.
Exercise-induced fatigue is a common consequence of physical activities. Particularly in older adults, it can affect gait performance. Due to a wide variety in fatiguing protocols and gait parameters used in experimental settings, pooled effects are not yet clear. Furthermore, specific elements of fatiguing protocols (i.e., intensity, duration, and type of activity) might lead to different changes in gait parameters. We aimed to systematically quantify to what extent exercise-induced fatigue alters gait in community-dwelling older adults, and whether specific elements of fatiguing protocols could be identified.
This systematic review and meta-analysis was conducted in accordance with the PRISMA guidelines. In April 2023, PubMed, Web of Science, Scopus, Cochrane and CINAHL databases were searched. Two independent researchers screened and assessed articles using ASReview, Rayyan, and ROBINS-I. The extracted data related to spatio-temporal, stability, and variability gait parameters of healthy older adults (55 +) before and after a fatiguing protocol or prolonged physical exercise. Random-effects meta-analyses were performed on both absolute and non-absolute effect sizes in RStudio. Moderator analyses were performed on six clusters of gait parameters (Dynamic Balance, Lower Limb Kinematics, Regularity, Spatio-temporal Parameters, Symmetry, Velocity).
We included 573 effect sizes on gait parameters from 31 studies. The included studies reflected a total population of 761 older adults (57% female), with a mean age of 71 (SD 3) years. Meta-analysis indicated that exercise-induced fatigue affected gait with a standardized mean change of 0.31 (p < .001). Further analyses showed no statistical differences between the different clusters, and within clusters, the effects were non-uniform, resulting in an (indistinguishable from) zero overall effect within all clusters. Elements of fatiguing protocols like duration, (perceived) intensity, or type of activity did not moderate effects.
Due to the (mainly) low GRADE certainty ratings as a result of the heterogeneity between studies, and possible different strategies to cope with fatigue between participants, the only conclusion that can be drawn is that older adults, therapist, and researchers should be aware of the small to moderate changes in gait parameters as a result of exercise-induced fatigue.
运动引起的疲劳是体育活动的常见后果。特别是在老年人中，它会影响步态表现。由于实验设置中使用的疲劳方案和步态参数种类繁多，综合效应尚不清楚。此外，疲劳方案的特定要素（即强度、持续时间和活动类型）可能会导致步态参数的不同变化。我们旨在系统地量化运动引起的疲劳在多大程度上改变社区居住老年人的步态，以及是否可以确定疲劳方案的特定要素。
本系统评价和荟萃分析按照PRISMA指南进行。2023年4月，检索了PubMed、Web of Science、Scopus、Cochrane和CINAHL数据库。两名独立研究人员使用ASReview、Rayyan和ROBINS-I筛选和评估文章。提取的数据涉及健康老年人（55岁以上）在疲劳方案或长时间体育锻炼前后的时空、稳定性和变异性步态参数。在RStudio中对绝对和非绝对效应量进行随机效应荟萃分析。对六类步态参数（动态平衡、下肢运动学、规律性、时空参数、对称性、速度）进行调节分析。
我们纳入了31项研究中关于步态参数的573个效应量。纳入的研究反映了总共761名老年人（57%为女性）的总体情况，平均年龄为71岁（标准差3岁）。荟萃分析表明，运动引起的疲劳影响步态，标准化平均变化为0.31（p < 0.001）。进一步分析表明，不同类别之间没有统计学差异，并且在类别内部，效应也不一致，导致所有类别中的总体效应（与）零无差异。疲劳方案的要素，如持续时间、（感知）强度或活动类型，并未调节效应。
由于研究之间的异质性导致（主要）低GRADE确定性评级，以及参与者之间应对疲劳的可能不同策略，唯一可以得出的结论是，老年人、治疗师和研究人员应该意识到运动引起的疲劳会导致步态参数出现小到中等程度的变化。
