A systematic review of one-legged balance performance and falls risk in community-dwelling adults

Blodgett, Joanna M.; Ventre, Jodi; Mills, Richard; Hardy, Rebecca; Cooper, Rachel

doi:10.1016/j.arr.2021.101501

Cited by 10 publications

(17 citation statements)

References 119 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Participants performed 1 eye open and 1 eye closed trial; eyes open times were used in these analyses because they are the most common visual condition for this test. 33 Individuals who were unable to perform the test because of health reasons were allocated a balance time of 0 seconds (n=61 at age 53 years only, n=75 at age 60−64 years only, n=14 at both ages). 44 A total of 5 groups indicated a change in balance performance from age 53 years to 60−64 years: stable high (30 seconds at both ages), stable middle (15 to <30 seconds), stable low (0 to <15 seconds), and improved and declined (moving from better to worse categories between ages 53 years and 60−64 years, respectively).…”

Section: Methodsmentioning

confidence: 99%

One-Legged Balance Performance and Fall Risk in Mid and Later Life: Longitudinal Evidence From a British Birth Cohort

Blodgett¹,

Hardy²,

Davis³

et al. 2022

American Journal of Preventive Medicine

Self Cite

View full text Add to dashboard Cite

Section: Methodsmentioning

confidence: 99%

One-Legged Balance Performance and Fall Risk in Mid and Later Life: Longitudinal Evidence From a British Birth Cohort

Blodgett¹,

Hardy²,

Davis³

et al. 2022

American Journal of Preventive Medicine

Self Cite

View full text Add to dashboard Cite

“…One commonly used screening tool is the one-legged balance test, commended for its parsimony and low-cost (8)(9)(10)(11). The adoption of the test in clinical and population settings is primarily based on evidence from observational studies demonstrating that better balance performance is associated with decreased risk of falls (7,(12)(13)(14).…”

Section: Introductionmentioning

confidence: 99%

“…The two most common recommendations in clinical fall prevention guidelines include exercise interventions and risk stratification screening, specifically assessing fall history in the last year and balance or gait impairments ( 1 , 2 ). While there is robust evidence demonstrating that functional balance and strength training programmes can reduce fall risk ( 3 , 4 ), there is limited evidence indicating that a balance or gait assessment, in isolation or in combination with fall history, can accurately predict fall risk ( 2 , 5 – 7 ). One commonly used screening tool is the one-legged balance test, commended for its parsimony and low-cost ( 8 – 11 ).…”

Section: Introductionmentioning

confidence: 99%

“…However, a recent systematic review highlighted that the evidence examining associations between one-legged balance and fall risk is poor, relying largely on cross-sectional data ( 7 ). It concluded that there was insufficient evidence investigating the prognostic ability of the one-legged balance test in accurately predicting falls.…”

Section: Introductionmentioning

confidence: 99%

“…This is concerning for ongoing translation, given that a population-level association does not necessarily equate with prediction at an individual level ( 15 – 17 ). Although successful balance strategies that involve proactive or reactive adaptations are directly involved in avoiding a fall ( 18 – 20 ), there is insufficient investigation as to whether poor one-legged balance performance predicts subsequent falls and what constitutes the threshold for a positive screening result ( 7 ).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Prognostic accuracy of the one-legged balance test in predicting falls: 15-years of midlife follow-up in a British birth cohort study

Blodgett

Hardy²,

Davis³

et al. 2023

Front. Sports Act. Living

Self Cite

View full text Add to dashboard Cite

IntroductionThe one-legged balance test is a common screening tool for fall risk. Yet, there is little empirical evidence assessing its prognostic ability. The study aims were to assess the prognostic accuracy of one-legged balance performance in predicting falls and identify optimal cut-points to classify those at greater risk.MethodsData from up to 2,000 participants from a British birth cohort born in 1,946 were used. The times an individual could stand on one leg with their eyes open and closed were recorded (max: 30 s) at ages 53 and 60–64. Number of falls in the past year was self-reported at ages 53, 60–64 and 68; recurrent falls (0–1 vs. 2+) and any fall (0 vs. 1+) were considered binary outcomes. Four longitudinal associations between balance times and subsequent falls were investigated (age 53 → 60–64; age 53 → 68; age 60–64 → 68; age 53 & 60–64 → 68). For each temporal association, areas under the curve (AUC) were calculated and compared for a base sex-only model, a sex and balance model, a sex and fall history model and a combined model of sex, balance and fall history. The Liu method was used to identify optimal cut-points and sensitivity, specificity, and AUC at corresponding cut-points.ResultsMedian eyes open balance time was 30 s at ages 53 and 60–64; median eyes closed balance times were 5 s and 3 s, respectively. The predictive ability of balance tests in predicting either fall outcome was poor (AUC range for sex and balance models: 0.577–0.600). Prognostic accuracy consistently improved by adding fall history to the model (range: 0.604–0.634). Optimal cut-points ranged from 27 s to 29 s for eyes open and 3 s to 5 s for eyes closed; AUC consistently indicated that using “optimal” cut-points to dichotomise balance time provided no discriminatory ability (AUC range:0.42–0.47), poor sensitivity (0.38–0.61) and poor specificity (0.23–0.56).DiscussionDespite previous observational evidence showing associations between better one-legged balance performance and reduced fall risk, the one-legged balance test had limited prognostic accuracy in predicting recurrent falls. This contradicts ongoing translation of this test into clinical screening tools for falls and highlights the need to consider new and existing screening tools that can reliably predict fall risk.

show abstract

Postural adaptations within normalized stability between older adults with and without chronic low back pain

Lee,

Sung

2023

Eur Spine J

View full text Add to dashboard Cite

A systematic review of one-legged balance performance and falls risk in community-dwelling adults

Cited by 10 publications

References 119 publications

One-Legged Balance Performance and Fall Risk in Mid and Later Life: Longitudinal Evidence From a British Birth Cohort

One-Legged Balance Performance and Fall Risk in Mid and Later Life: Longitudinal Evidence From a British Birth Cohort

Prognostic accuracy of the one-legged balance test in predicting falls: 15-years of midlife follow-up in a British birth cohort study

Postural adaptations within normalized stability between older adults with and without chronic low back pain

Contact Info

Product

Resources

About