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jansons-isankleplantarflexor-2021.pdf (1.51 MB)

Is ankle plantar flexor strength associated with balance and walking speed in healthy people? A systematic review and meta-analysis

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journal contribution
posted on 2021-04-01, 00:00 authored by Sanam Tavakkoli Oskouei, Peter Malliaras, Paul JansonsPaul Jansons, Keith Hill, Sze-Ee Soh, Shapour Jaberzadeh, Luke Perraton
Objective The purpose of this study was to investigate the association between ankle plantar flexor muscle (PF) strength and balance and walking speed in healthy adults. Methods Four databases (Ovid MEDLINE, Ovid EMBASE, CINAHL Plus, and SPORTDiscus) were searched from inception to December 2019. Studies with any design were included if the association between PF strength and balance and walking speed was investigated among healthy adults. Articles were screened for eligibility independently by 2 reviewers. Study characteristics and Pearson r values derived from the association between PF strength and balance and walking speed were extracted. Thirty-four studies were eligible. The main group of interest in the studies was older adults. Pearson r values were transformed to rz values using Fisher z-transformation. Meta-analysis of rz values was conducted and then back-transformed to r. Results In older adults, PF maximal isometric strength had a positive weak association with static balance (r = 0.20; 95% CI = 0.08–0.32), a positive moderate association with dynamic reactive balance (r = 0.42; 95% CI = 0.32–0.57) and proactive balance (r = 0.55; 95% CI = 0.18–1.06), and a positive weak association with preferred walking speed (r = 0.29; 95% CI = 0.19–0.41) and maximum walking speed (r = 0.34; 95% CI = 0.06–0.63). In younger adults, there was a moderate association between early-phase PF rate of torque development and reactive balance (0.42 < r < 0.52). Conclusions PF strength appears to be moderately associated with dynamic reactive and proactive balance and weakly associated with static balance and walking speed. This finding highlights the potential role of PF strength in dynamic reactive and proactive balance. Impact This meta-analysis showed that ankle PF strength might be important for challenging dynamic balance tasks.

History

Journal

Physical therapy

Volume

101

Pagination

1-12

Location

Oxford, Eng.

Open access

  • Yes

ISSN

0031-9023

eISSN

1538-6724

Language

eng

Publication classification

C1 Refereed article in a scholarly journal

Issue

4

Publisher

Oxford University Press