Mortality Risk Linked With Balance on One LegJune 21, 2022
The ability to complete a 10-second one-legged stance in mid- to late life was associated with all-cause mortality, longitudinal data showed.
People who could not hold a one-legged stance for 10 seconds had nearly twice the risk of death over the next 7 years (HR 1.84, 95% CI 1.23-2.78, P<0.001), after adjusting for age, sex, BMI, and comorbidities, reported Claudio Gil Araujo, MD, PhD, of Clinimex Medicina do Exercicio in Rio de Janeiro, Brazil, and co-authors in the British Journal of Sports Medicine.
Previous research has linked one-legged standing time, a measure of postural instability, with cognitive decline and asymptomatic cerebrovascular damage.
But overall, there’s little research linking one-legged stance to clinical outcomes other than falls, Araujo and colleagues pointed out.
“The advantages of the 10-second one-legged stance test include that it is simple and it provides rapid, safe, and objective feedback for the patient and healthcare providers regarding static balance,” Araujo told MedPage Today.
“It can be easily incorporated into the routine of the most clinical consultations, especially for older adults,” he added. “Importantly, the 10-second one-legged stance results add useful information regarding mortality risk in middle-age and older men and women beyond ordinary clinical data.”
The researchers included 1,702 participants ages 51 to 75 in the Clinimex Exercise cohort study, which was started in 1994 to evaluate fitness, health, and cardiovascular risk factors.
Participants had a mean age of 61.7 at their first checkup from February 2009 to December 2020, and most (68%) were men.
Only people with stable gait were included in the study. As part of the checkup, participants were asked to stand on one leg for 10 seconds without additional support.
Barefoot participants were asked to place the front of their free foot on the back of the opposite lower leg, keeping their arms down by their sides while looking straight ahead. Up to three attempts on either foot were permitted.
Overall, 20.4% of participants failed the 10-second test. Failure rate rose with age: it was 4.7% in 51- to 55-year-olds, 8.1% in 56- to 60-year-olds, 17.8% in 61- to 65-year-olds, and 36.8% in 66- to 70-year-olds. Over half of those ages 71-75 (53.6%) could not successfully complete the test.
During a median follow-up of 7 years, 7.2% of participants died, including 4.6% of people who could complete the test and 17.5% of those who could not.
Adjusting only for age, the HR for all-cause mortality was 2.18 (95% CI 1.48-3.22, P<0.001). “It is quite amazing that the magnitude of the difference in HR between age-adjusted and multivariable-adjusted mortality was so small,” Araujo said.
Those who failed the test generally had poorer health: a higher proportion were obese or had heart disease, hypertension, or dyslipidemia. Type 2 diabetes was three times as common in this group.
The study was observational and can’t establish cause, Araujo and colleagues acknowledged. All participants were white Brazilians, and results may not apply to other populations. In addition, potential confounders such as recent history of falls, physical activity levels, diet, smoking, and medication use may have influenced results.
This study received partial funding from CNPq and FAPERJ research agencies.