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Single-Leg Stance Test as a Reliable Indicator for All-Cause Mortality

The ability to complete a single leg stance for 10 seconds correlated with all-cause mortality in middle-aged and older individuals, according to study findings published in the British Journal of Sports Medicine.

Researchers conducted a prospective cohort study obtaining anthropometric, clinical, and vital data for 1702 individuals aged 51 to 75 years between February 10, 2009 and December 10, 2020 in Brazil.

Anthropometric measurements included the sum of 6 skinfolds, waist circumference, body mass index (BMI), and waist-height ratio. Clinical data included medical history and medication use. Clinicians assessed static balance based upon the individual’s ability to stand on 1 leg for 10 seconds without loss of balance. The researchers assessed the impact of these different variables on survival rates and risk for mortality.

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Of the 1702 individuals, 348 (20.4%) failed the 10 second single-leg stance test which progressively increased with age. The age range and percentage of individuals who failed the single-leg stance test is as follows:

Age Groups (Years) Single-Leg Stance Test Results (%)
51-55 4.7
56-60 8.1
61-65 17.8
66-70 36.8
71-75 53.6

After a median of 7 years, 123 (7.2%) people died due to cancer (32%), cardiovascular disease (30%), respiratory disease (9%), and COVID-19 (7%). More individuals unable to complete the 10-second single-leg stance test died than those who could complete the balance test (17.5% vs. 4.6%; P <.001); however, the major causes of death did not significantly differ between these groups (P =.45).

Age, waist-height ratio, and BMI significantly differed between those who failed the 10-second single-leg stance test and those who completed it (all; P <.001). Overall, those who struggled with single-leg static balance reported more health conditions, including hypertension, dyslipidemia, obesity, coronary artery disease, and, most notably, diabetes mellitus, compared with the successful group (37.9% vs. 12.6%; P <.001).

A predictive model for all-cause mortality significantly improved after including the 10-second single-leg balance test to the risk factors (P =.002).

“The ability to successfully complete the 10-s [single-leg stance] is independently associated with all-cause mortality and adds relevant prognostic information beyond age, sex, and several other anthropometric and clinical variables,” the researchers stated. “There is potential benefit to including the 10-s [single-leg stance] as part of routine physical examination in middle-aged and older adults.”

Study limitations included lack of diversity among study participants, lack of repeat balance testing over time, and lack of analysis of potential confounding variables such as recent history of falls, physical activity levels, diet, smoking, and medications, all of which can negatively impact balance performance.


Araujo CG, de Souza E Silva CG, Laukkanen JA, et al. Successful 10-second 1-legged stance performance predicts survival in middle-aged and older individuals. Br J Sports Med. Published online June 21, 2022. doi:10.1136/bjsports-2021-105360