EvidenceCLimitedStudies in people with real weaknesses: small, short or conflicting trials, or observational studies only.
Sometimes, but not reliably. Some sway measures, especially side-to-side sway, are linked to later falls in some studies, and others found no link. Sway alone can't predict one person's falls.
Who it's for
Older adults having a fall-risk check; not shown to be reliable alone.
What to expect
Moderate accuracy at best, and results differ by which sway measure is used.
Watch out for
Test methods differ widely, so results from one lab may not carry over.
What the studies show
A review of 9 studies that followed older adults over time found that sway measured on a force platform (a pressure-sensing floor plate) was linked to later falls in 5 studies. In the other 4, no link appeared. Side-to-side sway measures were the most consistent3Systematic review · 2006Force platform measurements as predictors of falls among older people - a review.Despite a wide search only a few prospective follow-up studies using the force platform technique to measure postural balance and a reliable registration of subsequent falls were found. The results suggest that certain aspects of force platform data may have predictive value for subsequent falls, especially various…Gerontology.
A trial-free cohort study Researchers follow a group of people over time without giving them a treatment. It can show links, not cause and effect. of 100 volunteers aged 62 to 96, followed for one year, found side-to-side sway with eyes covered was the best single predictor of falls. It predicted with moderate accuracy, even in people with no recent falls6Observational study · 1994 · 100 peopleA prospective study of postural balance and risk of falling in an ambulatory and independent elderly population.The results suggest that control of lateral stability may be an important area for fall-preventative intervention. The ability of a simple and safe force-plate measure of spontaneous postural sway to predict future falling risk suggests a possible clinical application as a preliminary screening tool for risk of…J Gerontol.
A second study in 100 residents of care homes (average age 83) found the same sway measure gave the best predictions of falls in general. It did not predict falls with no obvious physical trigger10Observational study · 1993Are activity-based assessments of balance and gait in the elderly predictive of risk of falling and/or type of fall?Activity-based testing of certain tasks (transfer, turning, reaching) may be useful in indicating a specific need for intervention to reduce the risk of falling during related everyday activities. In terms of predicting falling risk, a static posturography test may provide better prediction overall of the different…J Am Geriatr Soc.
A review pooling 19 forward-looking and 48 other studies found one measure, the area covered by the body's pressure point, was most consistently linked to falls. Adding mental tasks or removing vision gave no extra benefit. Uneven measures limited the analysis1Meta-analysis · 2020Diagnostic Balance Tests for Assessing Risk of Falls and Distinguishing Older Adult Fallers and Non-Fallers: A Systematic Review with Meta-Analysis.No evidence was found for increased benefit of the body sway test when cognitive tasks were added, or the vision was eliminated. While our analyses are limited due to the unbalanced representation of different test and outcome measures across studies, we can recommend the single-leg test for the assessment of the risk…Diagnostics (Basel).
A review of 31 reviews, mostly low quality, found no single balance, gait or mobility test predicts falls with high certainty. Walking speed had the best support4Systematic review · 2022Predicting falls in older adults: an umbrella review of instruments assessing gait, balance, and functional mobility.In conclusion, we found that no single gait, balance or functional mobility assessment in isolation can be used to predict fall risk in older adults with high certainty. Moderate evidence suggests gait speed can be useful in predicting falls and might be included as part of a comprehensive evaluation for older adults.BMC Geriatr.
A study of 316 healthy adults over 60, followed for 3 years, found that standing on one leg for under 5 seconds was linked to about twice the risk of injurious falls. It did not predict falls overall7Observational study · 1997 · 316 peopleOne-leg balance is an important predictor of injurious falls in older persons.One-leg balance appears to be a significant and easy-to-administer predictor of injurious falls, but not of all falls. In our study, it was the strongest individual predictor. However, no single factor seems to be accurate enough to be relied on as a sole predictor of fall risk or fall injury risk because so many…J Am Geriatr Soc.
Group-level figures like these compare people with and without a trait, so the gain for one person depends on how high their risk was to begin with.
Key studies
Study
Who
What it found
Review of 9 follow-up studies, 20063Systematic review · 2006Force platform measurements as predictors of falls among older people - a review.Despite a wide search only a few prospective follow-up studies using the force platform technique to measure postural balance and a reliable registration of subsequent falls were found. The results suggest that certain aspects of force platform data may have predictive value for subsequent falls, especially various…Gerontology
Older adults
5 studies linked force-plate sway to falls; 4 did not
Study following 100 people for 1 year, 19946Observational study · 1994 · 100 peopleA prospective study of postural balance and risk of falling in an ambulatory and independent elderly population.The results suggest that control of lateral stability may be an important area for fall-preventative intervention. The ability of a simple and safe force-plate measure of spontaneous postural sway to predict future falling risk suggests a possible clinical application as a preliminary screening tool for risk of…J Gerontol
Ages 62 to 96
Side-to-side sway predicted falls with moderate accuracy
Study following 100 people for 1 year, 199310Observational study · 1993Are activity-based assessments of balance and gait in the elderly predictive of risk of falling and/or type of fall?Activity-based testing of certain tasks (transfer, turning, reaching) may be useful in indicating a specific need for intervention to reduce the risk of falling during related everyday activities. In terms of predicting falling risk, a static posturography test may provide better prediction overall of the different…J Am Geriatr Soc
Care-home residents, average age 83
Sway gave best overall fall prediction
Review of 67 studies, 20201Meta-analysis · 2020Diagnostic Balance Tests for Assessing Risk of Falls and Distinguishing Older Adult Fallers and Non-Fallers: A Systematic Review with Meta-Analysis.No evidence was found for increased benefit of the body sway test when cognitive tasks were added, or the vision was eliminated. While our analyses are limited due to the unbalanced representation of different test and outcome measures across studies, we can recommend the single-leg test for the assessment of the risk…Diagnostics (Basel)
Older adults
Pressure-area sway most consistently linked to falls
Review of 31 reviews, 20224Systematic review · 2022Predicting falls in older adults: an umbrella review of instruments assessing gait, balance, and functional mobility.In conclusion, we found that no single gait, balance or functional mobility assessment in isolation can be used to predict fall risk in older adults with high certainty. Moderate evidence suggests gait speed can be useful in predicting falls and might be included as part of a comprehensive evaluation for older adults.BMC Geriatr
Older adults
No single test predicts falls reliably; walking speed best
What we don't know
Which sway measure, if any, predicts falls well enough to use for screening, since studies used different measures and could not be pooled1Meta-analysis · 2020Diagnostic Balance Tests for Assessing Risk of Falls and Distinguishing Older Adult Fallers and Non-Fallers: A Systematic Review with Meta-Analysis.No evidence was found for increased benefit of the body sway test when cognitive tasks were added, or the vision was eliminated. While our analyses are limited due to the unbalanced representation of different test and outcome measures across studies, we can recommend the single-leg test for the assessment of the risk…Diagnostics (Basel),3Systematic review · 2006Force platform measurements as predictors of falls among older people - a review.Despite a wide search only a few prospective follow-up studies using the force platform technique to measure postural balance and a reliable registration of subsequent falls were found. The results suggest that certain aspects of force platform data may have predictive value for subsequent falls, especially various…Gerontology.
How much sway adds to walking speed, age, past falls and other known risk factors4Systematic review · 2022Predicting falls in older adults: an umbrella review of instruments assessing gait, balance, and functional mobility.In conclusion, we found that no single gait, balance or functional mobility assessment in isolation can be used to predict fall risk in older adults with high certainty. Moderate evidence suggests gait speed can be useful in predicting falls and might be included as part of a comprehensive evaluation for older adults.BMC Geriatr,5Meta-analysis · 2010Risk factors for falls in community-dwelling older people: a systematic review and meta-analysis.This meta-analysis provides comprehensive evidence-based assessment of risk factors for falls in older people, confirming their multifactorial etiology. Some nonspecific indicators of high baseline risk were also strong predictors of the risk of falling.Epidemiology.
Written by AI from the studies listed, without review by a clinician, and graded with the GRADE method. It can be wrong, so check the studies it cites. Education, not medical advice.