Digital technologies and biomarkers for locomotor capacity assessment in older adults: a systematic review (Preprint)

BACKGROUND Locomotor capacity, encompassed by endurance, balance, muscle strength, muscle function, muscle power, and joint function of the body, is a key determinant of functional ability in older adults. Digital technologies for objectively assessing locomotor capacity are increasingly developed. OBJECTIVE This systematic review aims to evaluate the current state of digital technologies, assessing their validity and reliability to establish a robust foundation for future technological advancements and facilitate their effective implementation in clinical and research settings. METHODS Systematic searches were conducted in six electronic databases from inception to Mar 7, 2025. Studies focusing on reliability and validity of digital technologies for assessing locomotor capacity in older adults were included. Standardized forms were utilized to extract data, and the methodological quality assessment and rating of measurement properties were conducted following the COSMIN guidelines. RESULTS A total of nine studies were included, of which eight assessed balance using inertial measurement units, smartphones, and force plates, and one assessed muscle power using smartphones. The methodological quality of measurement properties received inadequate or doubtful in seven studies. All included studies generally displayed sufficient test-retest reliability, criterion validity, convergent validity and discriminative validity, with only one study rated as insufficient quality for convergent validity. CONCLUSIONS The included studies demonstrated the potential of technology in balance assessment; however, most were limited by small sample sizes and methodological shortcomings. High-quality studies are required to determine the diagnostic efficacy of these technologies and to ensure the development of rigorously validated, age-friendly assessment instruments. CLINICALTRIAL PROSPERO CRD420251074143; https://www.crd.york.ac.uk/PROSPERO/view/CRD420251074143