Instrumental assessment of balance and gait in depression: A systematic review. (February 2020)

• Record Type: Journal Article
• Authors: Belvederi Murri, Martino; Triolo, Federico; Coni, Alice; Tacconi, Carlo; Nerozzi, Erika; Escelsior, Andrea; Respino, Matteo; Neviani, Francesca; Bertolotti, Marco; Bertakis, Klea; Chiari, Lorenzo; Zanetidou, Stamatula; Amore, Mario
• Is Part Of: Psychiatry research. Volume 284(2020)
• Publication Date: 2020-02
• Subjects: Agitation -- Depression -- Gait -- Postural stability -- Psychomotor retardation -- Slowing; Psychiatry -- Periodicals; Psychiatry -- periodicals; Psychiatrie -- Périodiques; 616.89
• DOI: 10.1016/j.psychres.2019.112687
• Languages: English
• ISSNs: 0165-1781

Abstract

Highlights: Motor abnormalities are important in depression but are assessed subjectively We reviewed studies assessing motor performance with instrumental procedures Depression is associated with impaired gait, balance and posture Motor abnormalities in old age likely depend on cognitive and physical comorbidities Antidepressants and exercise may ameliorate motor features of depression Abstract: Psychomotor symptoms of depression are understudied despite having a severe impact on patient outcomes. This review aims to summarize the evidence on motor features of depression assessed with instrumental procedures, and examine age-related differences. We included studies investigating posture, balance and gait ascertained with instrumental measurements among individuals with depressive symptoms or disorders. Studies on subjects with specific physical illnesses were excluded. Methodological quality was assessed with the Newcastle - Ottawa Scale (NOS) and PRISMA guidelines were followed. 33 studies (13 case-control, five cross-sectional, nine longitudinal and six intervention) with overall low-medium quality were included. Different instruments were employed to assess posture (e.g. digital cameras), balance (balance, stepping platform) or gait (e.g. Six-Minute-Walking Test, instrumented walkways). Results suggest that depression in adults is associated with significant impairments of posture, balance and gait. Motor abnormalities among depressed older adults may depend on the interplay of physical diseases, cognitive impairment and mood. Very few intervention studies measured motor symptoms as outcome. Available evidence suggests, however, that antidepressant drugs and physical exercise may be beneficial for motor abnormalities. Despite the lack of high-quality studies, instrumental assessments confirm the presence and importance of motor abnormalities in depression, with potential age-related differences in their pathophysiology.