This 23-second balance test more accurately predicts one’s fall risk

(Photo by Roman Samborskyi on Shutterstock)

SÃO PAOLO, Brazil — Falls among older adults aren’t just common, they’re deadly. According to the World Health Organization, falls rank as the second leading cause of injury-related death for people aged 65 and over worldwide. While this statistic is alarming, new research suggests a simple balance test could help identify those at risk before they experience a life-altering fall.

A study by scientists at the University of São Paulo has revealed that traditional balance testing methods may need a significant update. The research, which followed 153 adults aged 60-89, demonstrates that current 10-second balance tests might be missing crucial signs of fall risk in otherwise healthy older adults.

“The current model of the balance test is simple and only requires the elderly person to remain in each of the four positions – parallel feet, with one foot slightly in front of the other, with one foot in front of the other, and balanced on one foot – for 10 seconds in order to check for balance and mobility problems. However, our study showed something we already suspected: 10 seconds in each position is not enough,” says Daniela Cristina Carvalho de Abreu, coordinator of the Laboratory of Balance Assessment and Rehabilitation at the University of São Paulo, in a statement.

Rather than the current practice of testing multiple positions briefly, researchers found that focusing on just two challenging positions for longer durations could provide more accurate predictions of fall risk. Similarly, by extending the observation time to at least 23 seconds for heel-to-toe (tandem) and single-leg stances, healthcare providers can better identify who might fall in the coming months.

Most significantly, the study found that every extra second a person could maintain these challenging positions reduced their odds of falling in the next six months by 5%. This provides healthcare workers with a clear, measurable way to assess fall risk.

When comparing those who later experienced falls to those who didn’t, the differences were striking. People who fell during the study’s six-month follow-up period could only maintain the single-leg stance for an average of 10.4 seconds, compared to 17.2 seconds for those who didn’t fall. Similar patterns emerged in the heel-to-toe stance, with future fallers averaging 17.5 seconds versus 24.8 seconds for non-fallers.

While the study utilized sophisticated force platform technology to measure body sway, the researchers discovered that simply timing how long someone can hold these challenging positions provides reliable fall risk assessment. “This is important because it simplifies the test and guarantees access to it in any doctor’s office or health center since the platform is an expensive piece of equipment,” notes Dr. Abreu.

Gender differences emerged in the study’s findings. Male participants showed more body sway than females but maintained challenging positions longer, suggesting that some amount of sway might actually help with balance rather than indicate poor stability.

The research team hopes these findings will revolutionize fall risk assessment for people aged 60 and over, from primary care to specialist consultations. As Dr. Abreu explains, “Our study has come a long way and has important implications for clinical practice. Although falls are the second leading cause of unintentional injury death in older people worldwide, and annual balance testing is recommended, it’s rarely done in clinical practice. That’s why it was important for us to find a model that didn’t require any equipment, was simple, quick, and could predict falls.”