Unable to Stand on one Leg for 10 Secs Leads to Mortality
Now before you continue reading this, try to stand on one leg, with the second foot touching the thigh of the supporting leg — much like a flamingo. Can you pass 10 seconds while you’re doing it?
Balance is reasonably preserved until about age 60. However, as we age, we lose balance function through loss of sensory elements, the ability to integrate information and issue motor commands, and because we lose musculoskeletal function.
Those who are middle age or older and cannot maintain balance while standing on one leg for 10 seconds were nearly four times likely to die in the next seven years than those who can do that position. The conclusion comes from the results of a study in Brazil.
The study started from the fact that the ability to balance the body disappears rapidly after the age of 50 years and increases the risk for falling in certain situations or other forms of deteriorating health. This study wanted to examine this ability with all causes of death.
Seeing if a person can stand on one leg has long been used to test balance. This is because falls are a major killer for the elderly. Based on data from WHO, Falls are the second leading cause of unintentional injury deaths worldwide. Adults older than 60 years of age suffer the greatest number of fatal falls that are severe enough to require medical attention occur each year. Usually, if they fall, the result is a fractured pelvis that requires surgery, with some never being able to return to their original mobility.
A total of 1,700 people between the ages of 51 and 75 were asked to stand on one leg for 10 seconds, with the second foot touching the thigh of the supporting leg — much like a flamingo.
2 out of 10 failed the test
The ability to maintenance balance test decreased with age. Overall, 20 percent of participants were unable to stand on one leg for 10 sec. Half of those aged 70 years could not complete the test. The percentage rose to about 70 percent in people aged 76–80 years, and about 90 percent in those aged 81–85 years.
Those who were unable to do so had a higher mortality rate over the next seven years. During a median follow-up of seven years, 17.5 percent of people who could not complete the test had died vs 4.6 of those who completed the test successfully.
These findings maybe correlated with other factors, apart from disease factors. For example, the older you get, the less successful these balance tests are, and the older you are, the more likely you are to die earlier. Most of those over the age of 70 are unable to pass this test.
But when the results were adjusted for factors such as age, weight, gender and medical history, they still showed that those who failed to pass the balance test had a death rate twice as fast, with an 84 percent higher risk of death over the study period.
It is not clear how many falls contributed to the deaths of the 123 participants who died during the study. The main causes of death are cancer, heart attacks and respiratory illnesses, including Covid-19. The incidence of falls and recovery from surgery may have contributed to the deaths — for example, people with sudden mobility impairments may see their heart disease worsening — but such factors were not recorded.
Previous research has found that similar tests can give clues about our health. For example, a higher death rate from heart disease in older people correlated with slower walking speed, in a test in which they were asked to walk 6 meters as fast as possible. The overall mortality rate was also associated with poor grip, in which a person was asked to squeeze an object as hard as they could.
Should doctors start asking their patients to do the tests?
The research team, led by Claudio Gil Araujo of Clinimex, Rio de Janeiro, Brazil, said in their paper that there would be potential benefit to including the test as part of a routine physical examination of middle-aged and older patients. “It’s simple to include it in a training routine because it’s less than 2 minutes.”
What Should I Do Now?
The ability to stand on one leg depends not only on balance, but also, on leg strength. It is also related to overall body strength and physical fitness. Those with disease, like heart disease or cancer, tend to be more inactive and lose leg strength.
Because it may be overall fitness and strength that influences the relationship between passing the flamingo-style balance test and risk of death, the study doesn’t show that improving balance can help you live longer.
“In older adults, it’s likely that muscle strength is the most important fitness goal,” says Stensel.
Keeping your muscles strong can help with your balance and prevent falls and fall-related injuries. You are less likely to fall when your leg and hip muscles are strong.
National Institute of Aging gives recommendation of strength exercise which is suitable for older adults. They recommend them to do strength exercises for all of your major muscle groups at least 2 days per week, but avoid exercise the same muscle group on any 2 days in a row. Below are a few examples of strength exercises:
- Lifting weights
- Carrying groceries
- Gripping a tennis ball
- Overhead arm curl
- Arm curls
- Wall push-ups
- Lifting your body weight
- Using a resistance band
“But people with better balance obviously fall less often,” said Uzo Ehiogu, spokesman for the UK’s Chartered Society of Physiotherapy.
It’s understandable that the combination of strength and balance exercise will have better results on older adults. Balance exercises help prevent falls, a common problem in older adults that can have serious consequences. Many lower-body strength exercises also will improve your balance. Balance exercises include:
- Tai Chi, a “moving meditation” that involves shifting the body slowly, gently, and precisely, while breathing deeply.
- Standing on one foot.
- The heel-to-toe walk.
- The balance walk.
- Standing from a seated position.
