A systematic review of one-legged balance performance and falls risk in community-dwelling adults |
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| Institution: | 1. Institute of Sport, Exercise & Health, Division of Surgery & Interventional Science, University College London, 170 Tottenham Court Road, W1T 7HA, London, UK;2. Department of Sport and Exercise Sciences, Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, Oxford Road, M15 6BH, Manchester, UK;3. Department of Psychology, Health, Psychology and Communities Research Centre, Manchester Metropolitan University, Bonsall Street, M15 6GX, Manchester, UK;4. CLOSER, Social Research Institute, University College London, 55-59 Gordon Square, WC1H 0NU, London, UK;1. School of Medicine, Dentistry and Biomedical Science, Queens University Belfast, Belfast, United Kingdom;2. Northern Ireland Centre for Stratified Medicine, Biomedical Sciences Research Institute, University of Ulster, C-TRIC Building, Altnagelvin Area Hospital, Londonderry, United Kingdom;3. Meadowlands Ambulatory Care Centre, Belfast Health and Social Care Trust, Belfast, United Kingdom;1. Institute of Molecular Biology & Translational Medicine, The Affiliated People’s Hospital, Jiangsu University, Zhenjiang, Jiangsu 212002, China;2. Department of General Surgery, The Affiliated People’s Hospital, Jiangsu University, Zhenjiang, Jiangsu 212002, China;1. Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, Selangor Darul Ehsan 47500, Malaysia;2. Brain Research Institute Monash Sunway (BRIMS), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, Selangor Darul Ehsan 47500, Malaysia |
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| Abstract: | ObjectiveThe aim of this systematic review was to synthesise all published evidence on associations between one-legged balance performance and falls.MethodsMedline, EMBASE, CINAHL and Web of Science were systematically searched (to January 2021) to identify peer-reviewed, English language journal articles examining the association between one-legged balance performance and falls in community-dwelling adults.ResultsOf 4310 records screened, 55 papers were included (n = 36954 participants). There was considerable heterogeneity between studies including differences in study characteristics, ascertainment of balance and falls, and analytical approaches. A meta-analysis of the time that individuals could maintain the one-legged balance position indicated that fallers had worse balance times than non-fallers (standardised mean difference: −0.29 (95%CI:−0.38,−0.20) in cross-sectional analyses; −0.19 (−0.28, −0.09) in longitudinal analyses), although there was no difference in the pooled median difference. Due to between-study heterogeneity, regression estimates between balance and fall outcomes could not be synthesised. Where assessed, prognostic accuracy indicators suggested that one-legged balance was a poor discriminator of fall risk; for example, 5 of 7 studies demonstrated poor prognostic accuracy (Area Under the Curve <0.6), with most studies demonstrating poor sensitivity.ConclusionsThis systematic review identified 55 papers that examined associations between balance and fall risk, the majority in older aged adults. However, the evidence was commonly of low quality and results were inconsistent. This contradicts previous perceptions of one-legged balance as a useful fall risk tool and highlights crucial gaps that must be addressed in order to translate such assessments to clinical settings. |
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| Keywords: | One-legged balance Falls Systematic review Community-dwelling |
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