Anticipatory postural adjustments in older versus young adults: a systematic review and meta-analysis.

Autor: Duarte MB; Laboratory of Human Motricity Sciences, Federal University of Pará, Av. Generalíssimo Deodoro 01, Belém, Pará, 66050-160, Brazil.; Master's Program in Human Movement Sciences, Federal University of Pará, 448/475 Av. Generalíssimo Deodoro 01, Belém, Pará, 66050-160, Brazil., da Silva Almeida GC; Laboratory of Human Motricity Sciences, Federal University of Pará, Av. Generalíssimo Deodoro 01, Belém, Pará, 66050-160, Brazil.; Tropical Medicine Center, Federal University of Pará, Av. Generalíssimo Deodoro 92, Belém, Pará, 66050-240, Brazil., Costa KHA; Laboratory of Human Motricity Sciences, Federal University of Pará, Av. Generalíssimo Deodoro 01, Belém, Pará, 66050-160, Brazil.; Tropical Medicine Center, Federal University of Pará, Av. Generalíssimo Deodoro 92, Belém, Pará, 66050-240, Brazil., Garcez DR; University Hospital Bettina Ferro de Souza, Federal University of Pará, Rua Augusto Corrêa, n 1. Cep 66075-110, Guamá, Belém, Pará, Brazil.; Neuroscience and Cell Biology Graduate Program (PPGNBC), Federal University of Pará, Rua Augusto Corrêa, n 1. Cep 66075-110, Guamá, Belém, Pará, Brazil., de Athayde Costa E Silva A; Master's Program in Human Movement Sciences, Federal University of Pará, 448/475 Av. Generalíssimo Deodoro 01, Belém, Pará, 66050-160, Brazil., da Silva Souza G; Tropical Medicine Center, Federal University of Pará, Av. Generalíssimo Deodoro 92, Belém, Pará, 66050-240, Brazil., de Melo-Neto JS; Tropical Medicine Center, Federal University of Pará, Av. Generalíssimo Deodoro 92, Belém, Pará, 66050-240, Brazil., Callegari B; Laboratory of Human Motricity Sciences, Federal University of Pará, Av. Generalíssimo Deodoro 01, Belém, Pará, 66050-160, Brazil. callegari@ufpa.br.; Master's Program in Human Movement Sciences, Federal University of Pará, 448/475 Av. Generalíssimo Deodoro 01, Belém, Pará, 66050-160, Brazil. callegari@ufpa.br.
Jazyk: angličtina
Zdroj: Systematic reviews [Syst Rev] 2022 Nov 23; Vol. 11 (1), pp. 251. Date of Electronic Publication: 2022 Nov 23.
DOI: 10.1186/s13643-022-02116-x
Abstrakt: Background: Anticipatory postural adjustments (APAs) are a feedforward mechanism triggered in advance to a predictable perturbation, to help the individual counteract mechanical effects that the disturbance may cause. Whether or not this strategy is compromised in the elderly is not a consensus in the literature.
Methods: In this systematic review with meta-analysis, we investigated aging effects on postural control, based on anticipatory postural adjustments (APAs). We selected 11 eligible articles of the following databases: Lilacs, SciELO, PubMed, Cochrane Central, Embase, and CINAHL, involving 324 research participants, assessing their methodological quality and extracting electromyographic, posturographic, and kinematic measurements. We included studies that investigated the occurrence of APAs in healthy younger and older adults, published before 10th August 2022, in English. Studies involving participant with conditions that may affect balance or that did not report measures of onset or amplitude of electromyography (EMG), COP, or kinematics were excluded. To analyze the aggregated results from these studies, we performed the analysis based on the outcome measures (EMG, COP, or kinematic measures) used in individual studies. We calculated differences between younger and older adult groups as the mean differences between the groups and the estimated effect. Egger's test was conducted to evaluate whether this meta-analysis had publication bias.
Results: Through this review, older adults showed no significant difference in the velocity to perform a movement compared to the younger adults (MD 0.95, 95% CI -0.86, 2.76, I 2 = 82%), but both muscle onset and center of pressure (COP) onset were significantly more delayed in older than in younger adults: erector spinae (MD -31.44, 95% CI -61.79, -1.09, I 2 = 95%); rectus abdominis (RA) (MD -31.51, 95% CI -70.58, -3.57, I 2 = 85%); tibialis anterior (TA) (MD -44.70, 95% CI -94.30, 4.91, I 2 = 63%); soleus (SOL) (MD -37.74, 95% CI -65.43, -10.05, I 2 = 91%); gastrocnemius (GAS) (MD -120.59, 95% CI -206.70, -34.49, I 2 = 94%); quadriceps (Q) (MD -17.42, 95% CI -34.73, -0.12, I 2 = 0%); biceps femoris (BF) (MD -117.47, 95% CI -192.55, -42.70, I 2 = 97%); COP onset (MD -45.28, 95% CI -89.57, -0.98, I 2 = 93%), and COP apa (COPapa) (MD 2.35, 95% CI -0.09, 4.79, I 2 = 64%). These changes did not seem to be linked to the speed of movement but possibly to age-related physiological changes that indicated decreased motor control during APAs in older adults.
Conclusions: Older adults use different postural strategies that aim to increase the safety margin and stabilize the body to perform the movement, according to the requirements imposed, and this should be considered in rehabilitation protocols.
Systematic Review Registration: PROSPERO CRD420119143198.
(© 2022. The Author(s).)
Databáze: MEDLINE
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