Sensory Integration is Partially Associated with Gait Speed in Healthy Community-Dwelling Older Adults: A Systematic Review and Meta-analysis

Abstract

Introduction Integration of sensory inputs from the visual, somatosensory, and vestibular systems within the central nervous system is defined as sensory integration (SI), and it is important for regulating movements such as walking1,2. Aging, however, often leads to impairments in these systems, which may contribute to changes in gait among older adults3,4. Despite this, the association between gait speed and SI has yet to be thoroughly investigated. Research Question Is there an association between gait speed and SI in healthy community-dwelling older adults? Methods A systematic literature search was conducted in the PEDro, PUBMED, MEDLINE, and Web of Science databases in January 2025. The studies that evaluated SI and gait in healthy community- dwelling older adults were deemed eligible. The quality of the studies was assessed with Quality in Prognosis Studies (QUIPS). Correlation coefficients between gait speed and postural sway during standing with eyes open on a firm surface (EOF), eyes closed on a firm surface (ECF), eyes open on a compliant surface (EOC), and eyes closed on a compliant surface (ECC) were extracted. To examine the association between gait speed and reliance on visual and somatosensory inputs, correlation coefficients were calculated between gait speed and the Romberg Quotient (RQ = ECF/EOF) and the Proprioception Quotient (PQ = EOC/EOF), respectively5. The postural sway outcome measurements were grouped as sway area and sway velocity. Results Thirteen studies comprising 719 older adults (mean age 72.5 years, age range 60-102 years, 66.82% female) were included. A high risk of bias was identified across all studies. There were significant associations between gait speed and sway area during EOF (r:-0.235, p<0.001), ECF (r:-0.201, p<0.001), EOC (r:-0.198, p<0.001), and ECC (r:-0.186, p<0.004). No significant associations were observed between gait speed and sway velocity across any condition, including the Romberg Quotient (RQ) and Proprioception Quotient (PQ) (p > 0.486 for all), except for the in ECS condition, which showed a weak negative correlation (r = -0.149, p = 0.01). Discussion In conclusion, both greater sway area across all conditions and greater sway velocity in ECS were associated with slower gait speed. On the other hand, gait speed was surprisingly not linked to RQ or PQ. This finding may stem from the fact that SI enables compensation for deficiencies of a sensory system in healthy older adults6. It may also be due to the absence of SI measurements in dynamic contexts, as assessing SI in static conditions may not fully reflect the demands of gait. We recommend that future research prioritize the evaluation of SI during dynamic tasks that more accurately reflect the demands of gait.