Abstract
Objectives
Pain is a risk factor for falls in older adults, but the mechanisms are not well understood,
limiting our ability to implement effective preventive strategies. The aim of this
study was to systematically review and synthesize the literature that has examined
the impact of pain on static, dynamic, multicomponent, and reactive balance in community-dwelling
older adults.
Design
Systematic review and meta-analysis.
Setting and Participants
Studies from inception to March 2019 were identified from electronic databases (MEDLINE,
EMBASE, PsycINFO, CINAHL), contact with the primary authors, and reference lists of
included articles.
Methods
Cross-sectional and case-control studies that compared objective balance measures
between older (minimum age 60 years) adults with and without pain were included.
Results
Thirty-nine eligible studies (n = 17,626) were identified. All balance modalities
(static, dynamic, multicomponent, and reactive) were significantly poorer in participants
with pain compared to those without pain. Subgroup analyses revealed that chronic
pain (pain persisting ≥3 months) impaired balance more than pain of unspecified duration.
The effects of pain at specific sites (neck, lower back, hip, knee, and foot) on balance
were not significantly different.
Conclusions and Implications
Pain is associated with poor static, dynamic, multicomponent, and reactive balance
in community-dwelling older adults. Pain in the neck, lower back, hip, knee, and foot
all contribute to poor balance, and this is even more pronounced for chronic pain.
Comprehensive balance and pain characteristic assessments may reveal mechanisms underlying
the contribution of pain to instability and increased fall risk in older people.
Keywords
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Article info
Footnotes
The authors declare no conflicts of interest.
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