An investigation into the influence of biological sex, anthropometrics, footwear, and dual tasking on balance

Abstract

BACKGROUND: It remains unclear whether balance is influenced by biological sex, anthropometrics, wearing footwear, or dual tasking. Such information is important to aid clinical reasoning pertaining to assessment and rehabilitation. OBJECTIVE: To investigate the influence of biological sex, anthropometrics, footwear, physical activity and dual tasking (DT) on balance performance. METHODS: An observational study was performed on eighty-six healthy participants. Anthropometric assessment and static balance performance was evaluated, during double leg stance with eyes open (DLSEO) and eyes closed (DLSEC) and during single-leg-stance (SLS). All tasks were assessed with and without footwear and a cognitive task was introduced to assess the effect of DT on static balance performance. RESULTS: Generally, the static balance performance of females was better than males, across all balance tasks, with some large effect sizes (ES). In both sexes, without footwear tasks resulted in better balance during the DLSEC task but with footwear, static balance performance was better during SLS in males only. Overall minimal differences were observed between single and dual task with a large ES for SLS and DLSEO for females. Upper body size was moderately negatively correlated to static balance performance. CONCLUSION: Females outperformed males, footwear and DT had some, but minimal influence on static balance. Anthropometrics were moderately correlated with balance. Balance performance should be compared to unisex normative data sets and performed as a single task, with or without footwear.