title: Does physical exercise improve obstacle negotiation in the elderly? A systematic review.
abstract: BACKGROUND
  Physical exercise improves walking in the elderly but much less is known about its effect on more challenged gait, such as obstacle negotiation. We conducted a systematic review to discuss the effects of regular physical exercise on kinematics and kinetics of obstacle negotiation in the elderly.
  
  
  METHODS
  A comprehensive literature search revealed 859 citations for review, whereof 206 studies entered the full-text analysis. After application of inclusion and exclusion criteria, 13 studies were included in this systematic review.
  
  
  RESULTS
  Most of them presented a reasonable quality (average 0.68) but none of them reached the level of a randomized control trial. Interventions were heterogeneous, with training periods lasting from 5 days to 10 months. Studies assessed obstacle negotiation basically considering 3 types of testing paradigm, namely a walkway with either a single obstacle crossing, or with multiple obstacles, or else a treadmill with an obstacle avoidance task under time pressure.
  
  
  CONCLUSIONS
  In general, longer training programs had better results and very short ones were not effective. A weekly frequency of 2-3 times was the most common among the studies showing positive effects. Regardless of exercises types performed, most of them were effective and so far, there is no consensus about the best exercise for improving obstacle negotiation. A lack of studies on this topic still is evident. Including a record of fall score can further help in deciding which programs are to be preferred.
authors.affiliation: Exercise Research Laboratory, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
authors.forename: Eliane C
authors.initials: EC
authors.lastname: Guadagnin
authors.affiliation: Applied Neuromechanics Research Group, Laboratory of Neuromechanics, Federal University of Pampa, Uruguaiana, RS, Brazil.
authors.forename: Emmanuel S
authors.initials: ES
authors.lastname: da Rocha
authors.affiliation: Department of Kinesiology, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven, Heverlee, Belgium.
authors.forename: Jacques
authors.initials: J
authors.lastname: Duysens
authors.affiliation: Applied Neuromechanics Research Group, Laboratory of Neuromechanics, Federal University of Pampa, Uruguaiana, RS, Brazil. Electronic address: carpes@unipampa.edu.br.
authors.forename: Felipe P
authors.initials: FP
authors.lastname: Carpes
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D000375:Aging / Q000523:psychology; D001362:Avoidance Learning; D001696:Biomechanical Phenomena; D005080:Exercise Test; D005081:Exercise Therapy; D005684:Gait; D006801:Humans; D017008:Negotiating; D004856:Postural Balance; D011930:Reaction Time; D016138:Walking
keywords: Aging; Gait; Obstacle negotiation; Training