Balance provocation tests identify near falls in healthy community adults aged 40-75 years; an observational study

Background: Near falls, such as stumbles or slips without falling to the ground, are more common than falls and often lead to a fall. Purpose: The objective of this study was to investigate which balance tests differentiate near fallers from fallers and non-fallers. Methods: This cross-sectional, observational study assessed balance in healthy community dwelling adults aged 40–75 years. Participants reported falls and near falls in the previous 6 months. Balance testing was completed in the local community for static (i.e. feet together and single-leg stance) and dynamic balance (i.e. tandem walk, Functional Movement Screen hurdle step and lunge). Between-group comparative analysis of pass-fail for each balance test was undertaken. Results: Of 627 participants, there were 99 fallers (15.8%), 121 near fallers (19.3%) and 407 non-fallers (64.9%). Near fallers were twice as likely as non-fallers to fail single-leg stance eyes (OR 2.7, 95% CI 1.5–4.9), five tandem steps (OR 2.5, 95% CI 1.5–5.7), hurdle step (OR 2.9, 95% CI 1.4–5.8), and lunge (OR 2.5. 95% CI 1.5–4.1). The predictive capacity differentiates near fallers with a sensitivity of 73.3%. Discussion: A new battery of tests assessing static and dynamic balance identifies near fallers in seemingly healthy, community dwelling middle- and young-older-aged adults.