Muscle Strength Decline and Fall Risk in Older Rollator Users: A Scoping Review of Biomechanical and Clinical Evidence

This project hosts the protocol and supporting materials for a scoping review titled "Muscle Strength Decline and Fall Risk in Older Rollator Users: A Scoping Review of Biomechanical and Clinical Evidence." Purpose. Rollators are among the most commonly prescribed walking aids for older adults, intended to enhance stability and prevent falls. Paradoxically, however, rollator use has been identified as an independent risk factor for falling, with users experiencing fall rates that exceed those of non-users. A growing body of evidence suggests that age-related muscle strength decline — encompassing sarcopenia and dynapenia — may fundamentally alter the biomechanical strategies required for safe rollator-assisted ambulation, yet no existing review has systematically mapped the intersection of these three domains: (1) muscle strength decline, (2) rollator-assisted gait biomechanics, and (3) fall risk in older adults. This scoping review aims to fill that gap by synthesizing and mapping the available biomechanical and clinical evidence linking muscle strength decline to fall risk specifically in older rollator users. Scope. The review will follow the Joanna Briggs Institute (JBI) methodology for scoping reviews and will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The Population–Concept–Context (PCC) framework guides the research questions: the population comprises older adults (≥60 years) who use rollators or wheeled walkers; the concept encompasses the relationship between muscle strength decline (e.g., reduced grip strength, knee extension force, lower-limb power) and fall risk (e.g., fall incidence, fear of falling, balance confidence); and the context includes community, clinical, and institutional settings without geographical restriction. Systematic searches will be conducted across MEDLINE (via PubMed), Scopus, and Web of Science Core Collection, supplemented by backward and forward citation tracking. Expected outcomes. The review is expected to produce: (a) a comprehensive evidence map identifying the volume, nature, and methodological characteristics of studies at the intersection of muscle strength, rollator use, and falls; (b) an integrative conceptual framework linking muscle strength decline to altered rollator-assisted gait biomechanics and consequent fall risk; (c) identification of critical knowledge gaps and under-researched populations or outcome measures; and (d) evidence-informed recommendations for clinical assessment and exercise-based intervention strategies targeting rollator users. Findings will be presented through narrative synthesis accompanied by summary tables, a charting matrix, and a PRISMA-ScR flow diagram. Open Science. All project materials — including the registered protocol, search strategies, screening records, data charting forms, and the final charting dataset — will be made publicly available on this OSF project page upon manuscript acceptance.