Angela Julienne ^1* Evi Verbecque ² Stephane Besnard ¹

• ¹ Université de Caen Normandie, Caen, France
• ² University of Antwerp, Antwerp, Antwerp, Belgium

Postural control is a multisensory adaptive system performing predictive (anticipatory) and/or reactive (compensatory) actions, with varying degrees of accuracy, to maintain balance in changing environmental context. Common instrumentation to evaluate balance includes static and dynamic force platforms; added sway-referenced perturbations on the dynamic platform constitute its main advantage. Clinical applications notwithstanding, normative data are needed for interpretation in clinical settings. Posturography norms are used to compare a reference group (healthy individuals) and a specific patient population. To our knowledge, this work represents the first attempt to synthesize the literature on normative data for computerized posturography using a combined mixed method. The search strategy resulted in the retrieval of 1244 articles from PubMed, Web of Science and Science Direct. After deduplication, 689 papers remained and were screened based on title and abstract. One hundred and seven articles met the criteria after the first screening. In depth full text screening resulted in the inclusion of 44 studies for the systematic and 17 studies for the meta-analyses. Main findings of this systematic review are: 1) extensive heterogeneity was found in methodological characteristics, 2) there was insufficient risk of bias mitigation, 3) most tasks evaluated less than four components of the SFPC, 4) studies mostly used distance domain sway parameters and did not report the influence of other variables on postural sway. Based on the multilevel meta-analyses, females appeared to significantly outperform males in eyes closed conditions. Based on the network meta-analyses, we found that younger children swayed significantly more than those aged between 8 and 14 years in eyes open condition and closed. The results also revealed a significant difference in sway between individuals between 50 and 79 years old and younger individuals; with more instability observed in older participants in both eyes open and closed conditions. Thus, future studies need to ensure the following that enough information about participants is provided. Standardization of experimental conditions and sway parameters harmonization are still needed to ensure high-quality assessment. Finally, evidencebased management of postural impairments requires both age and gender-related normative data.