Table 2.
Summary of effect size and quality of evidence for each power, RTD, or RFD parameter in identifying prospective falls/history
| Study design | Lower-limb power, RTD, or RFD parameter | Effect measure and size [95% CI] |
No. of studies | Study design | Factors downgrading quality | Factors upgrading quality | Overall quality of evidence | ||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Risk of bias | Inconsistency | Indirectness | Imprecision | Publication bias | |||||||
| Prospective cohort studies | Average leg-press powera |
Pooled SMD: −0.17 [−0.23, −0.12] Pooled OR: 0.84 [0.79, 0.89] RR: Quartile 1: 1.00 Reference Quartile 2: 0.88 [0.81, 0.97] Quartile 3: 0.86 [0.77, 0.95] Quartile 4: 0.82 [0.73, 0.92] |
3 | −2 (No RCT) | No | No | No | No | NA | + 1 (Dose–response gradient) |
⊕ ⊕ ⊕ ○ Moderate |
|
Peak sit-to-stand powera Minimum sit-to-stand powera Average sit-to-stand power Normalized peak sit-to-stand powera Peak stand-to-sit power Minimum stand-to-sit power Average stand-to-sit power Normalized peak stand-to-sit power |
Cohen’s d: 0.41 0.40 0.08 0.38 0.28 0.19 0.07 0.25 |
1 | −2 (No RCT) | No | No | No | No | NA | + 1 (Dose–response gradient) |
⊕ ⊕ ⊕ ○ Moderate |
|
| Peak jumping powera |
OR: 0.91 [0.85, 0.98] |
1 | −2 (No RCT) | No | No | No | −1 (Sample size < 400) | NA | + 1 (Dose–response gradient) |
⊕ ⊕ ○○ Low |
|
|
RFD of entire lower limbs during the sit-to-stand task |
SMD: −0.33 [−0.75, 0.09] |
1 | −2 (No RCT) | No | No | No | No | NA | None |
⊕ ⊕ ○○ Low |
|
|
RTD of hip flexors during the MVIC task RTD of hip extensors during the MVIC task RTD of hip abductors during the MVIC task RTD of hip adductors during the MVIC task RTD of knee flexors during the MVIC task RTD of knee extensors during the MVIC task RTD of ankle dorsiflexors during the MVIC task RTD of ankle plantarflexors during the MVIC task |
OR: 0.80 [0.40, 1.58] 0.77 [0.33, 1.82] 1.00 [0.26, 3.80] 1.15 [0.34, 3.94] 0.41 [0.07, 2.22] 0.99 [0.59, 1.68] 1.35 [0.34, 5.25] 0.82 [0.13, 4.90] |
1 | −2 (No RCT) | No | No | No | −1 (Sample size < 400) | NA | + 1 (Dose–response gradient) |
⊕ ⊕ ○○ Low |
|
|
Minimum hip joint power during the favored-paced walking test Minimum knee joint power during the favored-paced walking test Peak ankle joint power during the favored-paced walking test |
Median Difference | 1 | −2 (No RCT) | No | No | No | −1 (Sample size < 400) | NA | None |
⊕ ○○○ Very low |
|
| Cross-sectional studies | Peak sit-to-stand powera |
Pooled SMD: −0.58 [−0.96, −0.20] |
3 | −2 (No RCT) | No | No | No | No | NA | None |
⊕ ⊕ ○○ Low |
| Average leg-press powera |
Pooled SMD: −0.49 [−0.87, −0.11] |
2 | −2 (No RCT) | No | No | No | −1 (Sample size < 400) | NA | None |
⊕ ○○○ Very low |
|
|
RTD of knee flexors during the MVIC taska RTD of ankle dorsiflexors during the MVIC task RTD of ankle plantarflexors during the MVIC task |
Pooled SMD: −0.57 [−0.98, −0.16] −0.23 [−0.63, 0.18] −0.25 [−0.65, 0.15] |
3 | −2 (No RCT) | No | No | No | −1 (Sample size < 400) | NA | None |
⊕ ○○○ Very low |
|
| RTD of knee extensors during the MVIC task |
Pooled SMD: −0.18 [−0.46, 0.11] |
4 | −2 (No RCT) | No | No | No | −1 (Sample size < 400) | NA | None |
⊕ ○○○ Very low |
|
| RTD of hip extensors during the MVIC task |
Pooled SMD: −0.75 [−1.98, 0.49] |
2 | −2 (No RCT) | No | No | No | −1 (Sample size < 400) | NA | None |
⊕ ○○○ Very low |
|
|
RTD of hip flexors during the MVIC task RTD of hip abductors during the MVIC task RTD of hip adductors during the MVIC task |
SMD: −0.04 [−0.75, 0.67] −0.34 [−1.06, 0.38] −0.24 [−0.95, 0.48] |
1 | −2 (No RCT) | No | No | No | −1 (Sample size < 400) | NA | None |
⊕ ○○○ Very low |
|
| Peak jumping power (a in female participants) |
SMD: −0.47 [−0.78, −0.15] |
1 | −2 (No RCT) | No | No | No | −1 (Sample size < 400) | NA | None |
⊕ ○○○ Very low |
|
|
Average power of knee flexors during the isokinetic contraction task at 90°/sa Average power of knee flexors during the isokinetic contraction task at 120°/s Average power of knee extensors during the isokinetic contraction task at 90°/sa Average power of knee extensors during the isokinetic contraction task at 120°/sa Average power of ankle dorsiflexors during the isokinetic contraction task at 90°/sa Average power of ankle dorsiflexors during the isokinetic contraction task at 120°/s Average power of ankle plantarflexors during the isokinetic contraction task at 90°/s Average power of ankle plantarflexors during the isokinetic contraction task at 120°/s |
SMD: −0.82 [−1.44, −0.21] −0.56 [−1.15, 0.04] −0.80 [−1.41, −0.19] −0.73 [−1.33, −0.12] −0.65 [−1.26, −0.05] −0.08 [−0.67, 0.50] −0.22 [−0.81, 0.36] −0.31 [−0.90, 0.28] |
1 | −2 (No RCT) | No | No | No | −1 (Sample size < 400) | NA | None |
⊕ ○○○ Very low |
|
|
Power of knee extensors during the concentric contraction task at 70% 1-RM |
SMD: 0.13 [−0.65, 0.91] |
1 | −2 (No RCT) | No | No | No | −1 (Sample size < 400) | NA | None |
⊕ ○○○ Very low |
|
The quality of evidence was rated based on the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) criteria
RTD rate of torque development, RFD rate of ground reaction force development; SMD standardized mean difference, OR odds ratio, RR risk ratio, MVIC maximal voluntary isometric contraction, RM repetition maximum, RCT randomized controlled trial, NA not applicable
aIndicates the parameter could significantly predict the prospective falls or identify the different fall histories