Impact of sensory afferences in postural control quantified by force platform in healthy older adults: systematic review and meta-analysis

Postural balance in older adults is a key research focus, as impaired balance significantly increases fall risk, potentially leading to severe injury or mortality. Given age-related sensory decline, force-platform posturography assessing sensory perturbation effects could elucidate postural control deficits in aging. This systematic review and meta-analysis examines older adults' ability to maintain quiet stance during sensory perturbations. We searched 8 databases for studies evaluating older adults' balance under various sensory conditions. We included 64 articles in this review, for a total number of 4481 subjects. Proprioceptive and visual afferences were the most explored. Meta-analyses were conducted when several studies shared similar procedures and domain analysis for older adults (OA), older fallers (OF), and young adults (YA). They showed a significant impact of visual deprivation on older adults' balance for positional, dynamic and frequential variables, while it was significant only in the positional and dynamic domains for younger adults. When proprioception was disturbed, all the meta-analyses showed a significant impact on older adults. We concluded that positional and dynamic variables are sensitive to sensory perturbations and therefore could be useful in geriatric balance assessment. However, we emphasize the variability in methodological approaches and reporting standards, which constrains the broader applicability of these findings. We posit that posturographic research requires standardization and the establishment of an expert consensus regarding clinically relevant variables to facilitate the integration of posturography into geriatric fall risk assessment protocols, preventive programs and rehabilitation care.