Background

Cognitive, sensory, and biomechanical factors may affect gait of older adults. Among biomechanical factors, reduced pelvis and trunk range of motion (ROM) were associated with slower gait speed, shorter step length, and increased susceptibility to fall in older adults.

Objective

To systematically review the studies that compared trunk and pelvic movement during gait among adults and older adults.

Methods

Electronic search was conducted on MEDLINE, EMBASE, and Cinahl from inception until May 2020. Studies that compared trunk and/or pelvis kinematics during gait between adults and older adults were included. The following data were extracted from studies: gait speed, walking surface, and pelvis trunk ROM during gait in the three planes of motion. Meta-analyses were calculated for slow, comfortable, and fast gait speeds using random effects models. GRADE determined the strength of evidence.

Results

Twelve studies were included in this review. There was moderate-quality evidence that older adults have reduced pelvic rotation ROM at comfortable speed (SMD = −0.90 [−1.35, −0.45]) and high-quality evidence that older adults also have reduced pelvic rotation ROM at fast walking speed (SMD = −1.55 [−3.43, −0.33]). In addition, there was low-quality evidence that older adults have reduced trunk rotation at fast walking speed (SMD = −0.63 [−1.23, −0.03]). There were no differences for pelvic and trunk movement in the sagittal and frontal planes.

Conclusion

There is low to high quality of evidence that older adults walk with less pelvic rotation ROM in comfortable and fast walking speeds, and less trunk rotation ROM during fast walking speed.

中文翻译：

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老年人在步态中是否会出现骨盆和躯干运动模式的改变？荟萃分析和 GRADE 建议的系统评价

背景

认知、感觉和生物力学因素可能影响老年人的步态。在生物力学因素中，骨盆和躯干运动范围（ROM）减少与老年人步态速度减慢、步长缩短以及跌倒的易感性增加有关。

客观的

系统回顾比较成人和老年人步态过程中躯干和骨盆运动的研究。

方法

从开始到 2020 年 5 月，在 MEDLINE、EMBASE 和 Cinahl 上进行了电子检索。其中包括比较成人和老年人步态期间躯干和/或骨盆运动学的研究。以下数据是从研究中提取的：步态速度、行走表面和步态期间三个运动平面的骨盆躯干活动度。使用随机效应模型计算慢步态、舒适步态和快步态速度的荟萃分析。等级决定了证据的强度。

结果

本次综述纳入了十二项研究。中等质量的证据表明，老年人在舒适速度下骨盆旋转活动度减少（SMD = -0.90 [-1.35，-0.45]），高质量证据表明老年人在快速行走时骨盆旋转活动度也减少（SMD = −1.55 [−3.43, −0.33])。此外，有低质量的证据表明老年人在快走时躯干旋转减少（SMD = -0.63 [-1.23，-0.03]）。骨盆和躯干在矢状面和额状面上的运动没有差异。

结论

低质量到高质量的证据表明，老年人在舒适和快速步行时骨盆旋转活动度较小，在快速步行时躯干旋转活动度较小。