Beam walking as a new measure of dynamic balance to predict falls

Abstract

Abstract Background Beam walking is a functional test to estimate dynamic balance. We characterized dynamic balance measured by the distance walked on beams of different widths in individuals with and without neurological conditions and determined if beam walking distance predicted prospective falls over 12 months. Methods Individuals with (n = 97) and without neurological conditions (n = 99, healthy, age 20–60) participated in this prospective longitudinal study. Falls analyses over 12-months were conducted. The summed distance walked under single and dual-task conditions 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 individuals. The distance walked on the 8-cm-wide beam decreased by 0.34m already in the 20-year-old group. This reduction was ~ 3x greater, 1.1m, in the 60-year-old group. In patients, beam walking distances decreased sharply by 0.8m on the 8 vs. 12cm beam and by additional 1.6m on the 4 vs. 8cm beam. Beam walking distance under single and dual-task conditions was linearly but weakly associated with age. Age, disease, and beam width affected distance walked on the beam. Beam walking distance predicted future falls. Based on receiver operating characteristic curve analyses, walking ~ 8.0 of the 12m 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 older adults and patients with neurological conditions. Future studies are needed to confirm our findings. Clinical Trial Registration Number: NCT03532984