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Meta-Analysis
. 2019 Apr 9;14(4):e0214434.
doi: 10.1371/journal.pone.0214434. eCollection 2019.

Age and sex differences in human balance performance from 6-18 years of age: A systematic review and meta-analysis

Simon Schedler  1 , Rainer Kiss  2 , Thomas Muehlbauer  1
Affiliations
Meta-Analysis

Age and sex differences in human balance performance from 6-18 years of age: A systematic review and meta-analysis

Simon Schedler et al. PLoS One. .

Abstract

Background: The process of growing leads to inter-individual differences in the timing of growth, maturational, and developmental processes during childhood and adolescence, also affecting balance performance in youth. However, differences in balance performance by age and sex in youth have not been systematically investigated yet.

Objective: The objective of the present study was to characterize and quantify age- and sex-related differences in balance performance in healthy youth.

Methods: A computerized systematic literature search was performed in the electronic databases PubMed, Web of Science, and SPORTDiscus. To be applicable for analysis, studies had to report at least one measure of static steady-state, dynamic steady-state, proactive or reactive balance in healthy children (6-12 years) and/or adolescents (13-18 years). Coding of the studies was done according to the following criteria: age, sex, and balance outcome. Study quality was assessed using the Appraisal tool for Cross-Sectional Studies. Weighted standardized mean differences were calculated and classified according to their magnitude.

Results: Twenty-one studies examined age-related differences in balance performance. A large effect for measures of static steady-state balance (SMDba = 1.20) and small effects for proxies of dynamic steady-state (SMDba = 0.26) and proactive balance (SMDba = 0.28) were found; all in favor of adolescents. Twenty-five studies investigated sex-related differences in balance performance. A small-sized effect was observed for static steady-state balance (SMDbs = 0.33) in favor of girls and for dynamic steady-state (SMDbs -0.02) and proactive balance (SMDbs = -0.15) in favor of boys. Due to a lack of studies, no analysis for measures of reactive balance was performed.

Conclusions: Our systematic review and meta-analysis revealed better balance performances in adolescents compared to children, irrespective of the measure considered. Sex-related differences were inconsistent. These findings may have implications for example in terms of trainability of balance in youth that should be investigated in future studies.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow chart illustrating the different phases of the search and selection.
Fig 2
Fig 2. Differences in measures of static steady-state balance by age (children vs. adolescents).
CI confidence interval, df degrees of freedom, SE standard error, IV inverse variance.
Fig 3
Fig 3. Differences in measures of dynamic steady-state balance by age (children vs. adolescents).
CI confidence interval, df degrees of freedom, SE standard error, IV inverse variance.
Fig 4
Fig 4. Differences in measures of proactive balance by age (children vs. adolescents).
CI confidence interval, df degrees of freedom, SE standard error, IV inverse variance.
Fig 5
Fig 5. Differences in measures of static steady-state balance by sex (boys vs. girls).
CI confidence interval, df degrees of freedom, SE standard error, IV inverse variance.
Fig 6
Fig 6. Differences in measures of dynamic steady-state balance by sex (boys vs. girls).
CI confidence interval, df degrees of freedom, SE standard error, IV inverse variance.
Fig 7
Fig 7. Differences in measures of proactive balance by sex (boys vs. girls).
CI confidence interval, df degrees of freedom, SE standard error, IV inverse variance.
See this image and copyright information in PMC

References

    1. Woollacott MH, Shumway-Cook A. Changes in posture control across the life span—a systems approach. Phys Ther. 1990;70(12):799–807. Epub 1990/12/01. . - PubMed
    1. Shumway-Cook A, Woollacott M. Motor control: translating research into clinical practice. Fifth Edition, international edition ed. Philadelphia: Wolters Kluwer; 2017.
    1. Granacher U, Muehlbauer T, Gollhofer A, Kressig RW, Zahner L. An intergenerational approach in the promotion of balance and strength for fall prevention—a mini-review. Gerontology. 2011;57(4):304–15. Epub 2010/08/20. 10.1159/000320250 . - DOI - PubMed
    1. Hayes KC, Spencer JD, Riach CL, Lucy SD, Kirshen AJ. Age-Related Changes in Postural Sway In: Winter D, Hayes K, Patla A, editors. Biomechanics IX-A. Champaign, IL: Human Kinetics; 1985. p. 383–7.
    1. Sheldon JH. The effect of age on the control of sway. Gerontol Clin (Basel). 1963;5:129–38. . - PubMed