步态参数在不同衰弱状态评估中应用的Meta分析

Application of gait parameters in assessing different states of frailty:a Meta-analysis

[目的]研究不同衰弱状态组的步态特征,为衰弱诊断提供参考步态参数。[方法]检索PubMed、Web of Science、the Cochrane Library、中国期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM)、维普(VIP)、万方数据库(WanFang Data)。文献选择人群为明确区分为衰弱、衰弱前期、非衰弱个体;结果测量为生物力学分析获得的定量步态变量。检索时间为建库至2019年6月30日。由2名研究者独立筛选文献、提取资料后,评价纳入研究质量,并采用RevMan 5.3软件进行Meta分析。[结果]最终纳入12篇文献。跨步时间、步长、步速、步频在不同衰弱状态组间差异均有统计学意义;单任务和双重任务下跨步时间在不同衰弱状态组间差异有统计学意义,步速在衰弱和非衰弱组间差异有统计学意义,步长仅在非衰弱组差异有统计学意义。[结论]现有数据表明,步速之外的步态参数有助于识别不同类别的衰弱。快速步行或添加认知干扰物等要求较高的任务可能会提高衰弱风险预测和分类的敏感性和特异性,建议辅助使用步态分析对衰弱进行早期评估。

Objective:To analyze the gait characteristics in different states of frailty,so as to provide the referable gait parameters for the diagnosis of frailty.Methods:Literature was retrieved from PubMed,Web of Science,the Cochrane Library,China National Knowledge Infrastructure(CNKI),Chinese Biomedical Database(CBM),VIP Database,and WanFang Database.The study objects of included literature were individuals who were explicitly diagnosed with frailty or pre-frailty and non-frailty.The quantitative gait variables obtained by biomechanical analysis was presented as the results.The retrieval time was from the establishment of the databases to June 30,2019.Screening of literature,extraction of data,and evaluation of quality of included studies were performed by two researchers independently.And software RevMan 5.3 was used to take a Mata-analysis.Results:Finally,a total of 12 articles were included.There were statistically significant differences in stride time,step length,step speed,and stride frequency among groups with different states of frailty.Under the backgrounds of single task and dual tasks,there was statistically significant difference on stride time in distinguishing different groups with different state of frailty.There was statistical difference on step speed between the frailty and non-frailty groups.And the difference on step length was statistically significant among groups at the state of non-frailty state.Conclusions:Existing data indicated that besides of step speed,other gait parameters could also help to identify different states of frailty.In addition,high-demand tasks,such as fast walking or adding matters of interfering cognition might improve the sensitivity and specificity of risk prediction and classification of frailty.It was recommended that gait analysis be used to assist in early assessment of frailty.