Center of pressure displacement characteristics differentiate fall risk in older people: A systematic review with meta-analysis

Abstract

Falling is the second most prevalent cause of accidental death in the world. Currently available clinical tests to assess balance in older people are insufficiently sensitive to screen for fall risk in this population. Laboratory tests that record the center of pressure (COP) trajectory could overcome this problem but despite their widespread use, the choice of COP trajectory features for use as a biomarker of fall risk lacks consensus. This systematic review and meta-analysis aimed at identifying the best COP characteristics to predict risk of falling in older adults. More than 4000 articles were screened; 44 (7176 older adults) were included in this study. Several COP parameters emerged as good indices to discriminate fallers from non-fallers. From sensitivity analysis, Sway area per unit time, anteroposterior mean velocity, and radial mean velocity were the best traditional features. In this study, identification of older people with a high fall risk was demonstrated using quiet-standing recordings. Such screening would also be useful for routine follow-up of balance changes in older fallers in clinical practice.

Characterizing Human Postural Stability by Using Features Extracted From the Correlation Structure of Ground Reaction Force Components

“…The COP velocity is typically characterized by its mean velocity (MV), its MV in the ML direction (MVML), and its MV in the AP direction (MVAP). This study chose MVAP as the benchmark COP feature because it has been considered the most sensitive measure in the assessment of postural balance performance [8], [48], [49] and is considered one of the best traditional COP features in identifying older people with high fall risk [23]. For the sake of comparison, this study also reports the results obtained by MVML.…”

“…Owing to the critical role of the COP in postural balance and the ease with which force plates can be used, COP features have been employed in approximately 60% of the published literature on postural control [6], [7]. Many COP features have been proposed for assessing the impacts of different healthrelated conditions on postural stability; these health-related conditions include aging [8], [9], peripheral neuropathy [10], musculoskeletal disorders [11], stroke [12], [13], spinal cord injury [14], concussion [15], cancer [16], frailty syndrome [17], symptomatic degenerative lumbar disease [18], Parkinson's disease [19], [20], multiple sclerosis [21], [22], and fall risk [23]. In addition, COP features have also been used to assess the impacts of special events such as pregnancy, [23], [24].…”

Idiosyncratic Characteristics of Postural Sway in Normal and Perturbed Standing

“…It generally changes while we age, being higher in children and adolescents, lower in young adults and higher again in older adults (Sheldon, 1963;Goble and Baweja, 2018). Larger sway in children is associated with immature developmental processes (Nolan et al, 2005;Rival et al, 2005;Schedler et al, 2019), while in older adults, it reflects degeneration of neural and musculoskeletal systems (Horak et al, 1989), and can be indicative of larger incidence of falls (Piirtola and Era, 2006;Quijoux et al, 2020). Postural sway also tends to be greater in people with various disabilities compared to healthy individuals (Hufschmidt et al, 1980;Cameron and Lord, 2010;Deschamps et al, 2014).…”

Postadychute-AG, Detection, and Prevention of the Risk of Falling Among Elderly People in Nursing Homes: Protocol of a Multicentre and Prospective Intervention Study

“…In addition, the number of parameters derived from the COP trajectory can quickly exceed several dozen and the experimental recording conditions vary greatly between studies (27). Determining which parameters in which experimental conditions are optimal to discriminate future fallers from elderly non-faller remains a difficult task (28)(29)(30).…”