Can you stand on 1 foot for 10 seconds? Go ahead, try it. If the answer is yes, the odds are good that you will live 7 more years. If the answer is no, the odds are still good that you will live 7 more years, but not quite as good.
If you’ve already tried this in the past month, you’re not alone. In June, the news wires got ahold of a study out of Brazil reporting that the ability to stand on 1 foot for 10 seconds predicts survival in middle-aged to older people. One of our readers heard about the 1-legged stance test on NPR’s Wait Wait… Don’t Tell Me, tried it, and shared the story with us. After everyone in the Shop tried it, we decided to read the original article to understand what this research was all about.
Claudio Gil Araujo and colleagues drew a sample of 1,702 people who were 51-75 years of age. They recorded a battery of descriptive, anthropometric, and health information on each participant. They also asked them to stand on 1 foot for 10 seconds. Participants were categorized as yes they could or no they could not stand for 10 seconds on 1 foot. Then the researchers waited for about 7 years to learn that the no group was 3.8 times more likely to die in the next 7 years as compared to the yes group.
That’s probably what you heard on the news when you decided to add a 1-legged stance to your daily exercise routine. The conclusion is accurate, but here’s a little more to consider.
Over the 7-year period during which participants were followed, 4.6% of the yes group died, 17.5% of the no group died, and 7.2% of all participants died. Therefore, regardless of your ability to pose like a flamingo, your chance of dying in the next 7 years is just over 7%. And even if you can do this party trick, your chance of dying within 7 years is still nearly 5%.
Another interesting observation was that those who could not stand on 1 foot for 10 seconds were older, heavier, and more likely to have high blood pressure, high cholesterol, diabetes, and heart disease. At first, we thought these factors introduced serious confound. Older, sicker people are more likely to die than younger, healthier ones. Maybe the differences in longevity had nothing to do with balance and everything to do with age and health.
But Araujo et al. deftly rejected this simplistic explanation when they controlled for differences in age, weight, and health history. Even after accounting for these factors, people who could not stand on 1 foot for 10 seconds were 1.84 times as likely to die as those who could.
Recall that the chance of dying in 7 years was 4.6% for those who could do the task. If you could not do it, the risk of dying in 7 years was 1.84 X 4.6%, or about 8.5%. The difference (4.6% vs. 8.5%) was statistically significant and meaningful. I’d take 4.6% over 8.5% any day. But it’s not as large as 4.6% vs. 17.5%, which was the difference before controlling for the other risk factors.
An alternative headline for the Brazilian study might have been “Old Age and Poor Health Predict Death.” But who would read that?!
Getting back to the 1-legged stance test, the results of this study are remarkable if not surprising. The test was meant to examine balance. It seems that balance adds prognostic information about how long we’ll live even after we account for our age, weight, and health. I’m tempted to think that poor balance contributes to falls and falls lead to death. But that’s speculation. Cause of death was not reported, and a correlation between balance and longevity says nothing about causation.
What are we to take from this serious piece of science that has received a lot of silly media attention? Here at the Shop, we’ve concluded that those of us between the ages of 51 and 75 have a really good chance of living 7 more years. We’ve also decided that we’re more likely to die as we age or get sick. (I know that one is a real shocker.) And finally, poor balance may further reduce our longevity.
In terms of action items, I think we’ll add some exercises to our daily routine that are designed to combat age-related balance loss. Effective balance training protocols include balancing on stable and unstable surfaces and obstacle walking. A daily flamingo pose may not be such a bad idea. For additional challenge, we could do it with our eyes closed or while standing on an old couch cushion. As for obstacle walking, that one’s easy. All we’ll need to do is make a point of walking across our kids’ bedroom floor.
Thanks for reading. Hope you’ll join me next time and in 7 years.
Sheila Schindler-Ivens received her B.S. in Physical Therapy from Marquette University (1989) and then worked in neurological rehabilitation for 4 years. She completed her master’s degree at Simon Fraser University (1997) and her Ph.D. at the University of Iowa (2001) where she studied neural control of movement in health and disease. Her postdoctoral training was completed at Northwestern University (2004). Dr. Schindler-Ivens joined Marquette University in 2005. She teaches Evidence Based Practice and is the director of the Neuromuscular Control of Movement Laboratory. Her research aims to understand the way in which the brain and spinal cord control human locomotion, and how the nervous system adapts to produce locomotion after brain injury. The long term objective of this research line it to develop better rehabilitation interventions for restoring walking in people with stroke.
- Lesinski M, Hortobágyi T, Muehlbauer T, Gollhofer A, Granacher U. Effects of Balance Training on Balance Performance in Healthy Older Adults: A Systematic Review and Meta-analysis. Sports Med. 2015 Dec;45(12):1721-38. doi: 10.1007/s40279-015-0375-y. Erratum in: Sports Med. 2016 Mar;46(3):457. PMID: 26325622; PMCID: PMC4656699.
- Araujo CG, de Souza e Silva CG, Laukkanen JA, et al. Successful 10-second one-legged stance performance predicts survival in middle-aged and older individuals. British Journal of Sports Medicine Published Online First: 21 June 2022. doi: 10.1136/bjsports-2021-105360.