A Systematic Review of the Biomechanical Impact of Load Carriage on Gait in Older Adults

Abstract

Objective: To examine the biomechanical effects of load carriage on gait patterns, joint kinematics, and muscle activity during walking in older adults. Methods: A systematic literature search was conducted across five databases (CNKI, Wanfang, VIP, PubMed, and Web of Science) through June 2025. Eight studies met the inclusion criteria. The methodological quality of included studies was assessed using the ROBINS-I Version 2 tool. Results: Asymmetrical load carriage during walking increases step frequency and step width, shortens step length and the gait cycle, induces lateral trunk tilt, and leads to asymmetric muscle activation between body sides. With increasing load, adverse effects on trunk posture and muscle activation become more pronounced, including a significant increase in contralateral hip joint torque. Symmetrical load carriage up to 5% of body weight has no significant effect on gait and may improve static postural stability in older adults. Conclusion: Both asymmetrical and heavier load carriage impose greater biomechanical demands on gait in older adults. Older adults are advised to carry loads symmetrically and keep the weight below 5% of body mass to maintain gait stability and reduce fall risk.