Single leg balance test

Predict longevity with this one simple test

Can something as simple as standing on one leg help predict how long you will live?

Person demonstrating good balance walking on a beam

The idea that we can predict longevity by testing balance comes from a 2022 study published in the British Journal of Sports Medicine. The study showed that in adults ages 51-75 years old, being able to stand on one leg for at least 10 seconds (an indication of balance) was associated with a higher 7-year survival rate compared to those unable to perform the task. This difference is present after correcting for age, sex, BMI, presence of heart disease, hypertension, and diabetes.

How does balance predict longevity? Falls are the leading cause of fatal and nonfatal injuries among persons aged ≥ 65 years. Falls result in more than 2.8 million injuries treated in emergency departments annually, including over 800,000 hospitalizations and more than 27,000 deaths. Research shows that balance and stability are essential for longevity and quality of life. Even if you’re not in the reported age range, your ability to balance is vital for your overall health and wellness. The good news is that you can improve your balance and stability in many ways, regardless of age.

Three factors contribute to balance

Balance is a measure of postural control and is the ability to maintain equilibrium.

1. Vision

The eye and vision are important for balance

Vision provides us with one-half to two-thirds of the input to the brain and is vitally important to maintaining balance. A simple way to demonstrate this is to stand upright and close your eyes. You’ll likely feel your body sway. This gets worse if you try to stand on one leg or with your feet close together. Maintaining balance control while walking through a dark or dimly lit area can also be tricky. In addition, someone with poor vision may find their balance is off when they aren’t wearing their glasses or contacts.
But visual clarity isn’t the only way our vision affects our balance.

If our depth perception is off, we may have difficulty with stairs or curbs. Convergence is also important. This is a measure of how well your eyes move together and focus on close objects. Normally, we can still focus clearly on objects six centimeters away. If our convergence is off, objects may appear to double a lot sooner, affecting focus and balance. The same applies to eye tracking, such as following an object moving up and down or side to side. Poor eye tracking can lead to poor balance.

2. Inner Ear (Vestibular System)

The inner ear is important to balance

Your inner ear monitors your movements by alerting your brain to changes. This allows your brain to let your body know what to do to stay balanced. It works closely with the visual system. One way to test the coordination of the inner ear and vision is to assess the VOR (vestibulo-occular reflex). This reflex keeps us steady and balanced even though our eyes and head continuously move when we perform most actions. It allows our eyes to remain focused when we make a head movement. You can test this reflex by staring at an item in front of you while moving your head from side to side or nodding while you maintain the object in focus. If this causes dizziness or you have difficulty focusing, your inner ear might be the culprit.

If you are suffering from vertigo (dizziness) and your balance is affected, additional issues may be at play in the inner ear, and it is best to be tested by an experienced healthcare professional.

3. Muscles and Joints (Somatosensory System)

Our muscles, joints, and tendons have sensors to help us understand where our body is in space. Balance is challenged if any of these is disrupted due to sprains, strains, arthritis, or surgery, to name a few. A good example of the somatosensory system in action is when we walk from a smooth surface (sidewalk) onto an uneven surface (grass). Our bodies sense the difference in the surfaces and adjust how we walk to remain stable. If, for example, you have suffered a recent ankle sprain, have back pain, or undergone surgery on your knee, the body cannot make these rapid adjustments as well.

Man exercising with balance

Balance is harmony between all three systems

Balance can predict longevity because the cost of falling is so high. Falls are the second leading cause of unintentional injury deaths worldwide. 37.3 million falls that are severe enough to require medical attention occur each year. Falls can cause significant injury and debilitation whether we are young or old. While our sense of balance does decrease with age, people of all ages can experience difficulty. If any of the systems are off, we may be at risk of falling. Determining which system is causing the most disruption is the key to improving balance. The answer may be easy, such as when you need a new prescription for your glasses. However, there may be more than one system affected at a time. Testing by a professional can help determine the cause and prescribe the proper exercises to get you back on steady feet!

man who lost his balance and fell down the stairs causing injury

Guide to reducing falls and improving balance

  • Rehab fully after injuries such as ankle sprains, knee surgery, or back strains
  • Incorporate balance into your regular workouts
  • Stay strong! Incorporate strength into your workouts, especially the core and legs
  • Keep living areas free of cords, throw rugs, and excess clutter
  • Use extra caution on changing or slippery surfaces
  • Make sure your footwear is well-fitting and appropriate for the activity
  • When performing balance exercises, use a wall or steady object for safety as needed
  • Get regular vision exams
  • Talk to your healthcare provider if you are experiencing dizziness
Demonstrating excellent balance walking on a beam

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Carol Grgic, PT, OCS, CSCS

Carol Grgic, PT, OCS, CSCS

Carol Grgic is the owner and treating therapist at Elite Bodyworks in the Historic Third Ward, in Milwaukee, Wisconsin. She has extensive experience treating athletes and active people of all levels. She also enjoys blogging about health and wellness topics.

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