Walking on a Balance Beam as a New Measure of Dynamic Balance to Predict Falls in Older Adults and Patients with Neurological Conditions

• Published in: Sports medicine - open Vol. 10; no. 1; pp. 59 - 12
• Main Authors: Hortobágyi, Tibor, Vetrovsky, Tomas, Uematsu, Azusa, Sanders, Lianne, da Silva Costa, Andréia Abud, Batistela, Rosangela Alice, Moraes, Renato, Granacher, Urs, Szabó-Kóra, Szilvia, Csutorás, Bence, Széphelyi, Klaudia, Tollár, József
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 22-05-2024; Springer Nature B.V; SpringerOpen
• Subjects: Age; Aging; Balance; Dual tasks; Falls; Gait; Medicine; Medicine & Public Health; NCT; NCT03532984; Older people; Original; Original Research Article; Sports Medicine; Falls; Aging; Gait; Balance; Dual tasks
• ISSN: 2198-9761; 2199-1170; 2198-9761
• DOI: 10.1186/s40798-024-00723-7

Background
Beam walking is a new test to estimate dynamic balance. We characterized dynamic balance measured by the distance walked on beams of different widths in five age groups of healthy adults (20, 30, 40, 50, 60 years) and individuals with neurological conditions (i.e., Parkinson, multiple sclerosis, stroke, age: 66.9 years) and determined if beam walking distance predicted prospective falls over 12 months.
Methods
Individuals with (n = 97) and without neurological conditions (n = 99, healthy adults, age 20–60) participated in this prospective longitudinal study. Falls analyses over 12 months were conducted. The summed distance walked under single (walking only) and dual-task conditions (walking and serial subtraction by 7 between 300 to 900) on three beams (4, 8, and 12-cm wide) was used in the analyses. Additional functional tests comprised grip strength and the Short Physical Performance Battery.
Results
Beam walking distance was unaffected on the 12-cm-wide beam in the healthy adult groups. The distance walked on the 8-cm-wide beam decreased by 0.34 m in the 20-year-old group. This reduction was ~ 3 × greater, 1.1 m, in the 60-year-old group. In patients, beam walking distances decreased sharply by 0.8 m on the 8 versus 12 cm beam and by additional 1.6 m on the 4 versus 8 cm beam. Beam walking distance under single and dual-task conditions was linearly but weakly associated with age (R
2
 = 0.21 for single task, R
2
 = 0.27 for dual-task). Age, disease, and beam width affected distance walked on the beam. Beam walking distance predicted future falls in the combined population of healthy adults and patients with neurological conditions. Based on receiver operating characteristic curve analyses using data from the entire study population, walking ~ 8.0 of the 12 m maximum on low-lying beams predicted future fallers with reasonable accuracy.
Conclusion
Balance beam walking is a new but worthwhile measure of dynamic balance to predict falls in the combined population of healthy adults and patients with neurological conditions. Future studies are needed to evaluate the predictive capability of beam walking separately in more homogenous populations.
Clinical Trial Registration Number
NCT03532984.
Key Points
Walking balance is normally inferred from walking speed to predict future fall in older adults
Beam walking distance sharply decreased with age in older versus younger adults
Beam walking distance decreased further strongly in individuals with neurological conditions
Beam walking distance (i.e., distance until first balance loss) predicted future falls in older adults and patients with neurological conditions
Walking ~ 8.0 of the 12 m maximum on low-lying beams predicted future fallers with reasonable accuracy