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

Blodgett, J; Ventre, JP; Mills, R; Hardy, R; Cooper, R; (2022) A systematic review of one-legged balance performance and falls risk in community-dwelling adults. Ageing Research Reviews , 73 , Article 101501. 10.1016/j.arr.2021.101501. Green open access

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Abstract

OBJECTIVE: The aim of this systematic review was to synthesise all published evidence on associations between one-legged balance performance and falls. METHODS: Medline, 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. RESULTS: Of 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. CONCLUSIONS: This 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.

Type: Article
Title: A systematic review of one-legged balance performance and falls risk in community-dwelling adults
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.arr.2021.101501
Publisher version: https://doi.org/10.1016/j.arr.2021.101501
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher's terms and conditions.
Keywords: One-legged balance, Falls, Systematic review, Community-dwelling
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Education
UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education
UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education > IOE - Social Research Institute
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci > Department of Targeted Intervention
URI: https://discovery.ucl.ac.uk/id/eprint/10137619
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