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The Role of Asymmetrical Strength Deficit on Balance and Fall Risk in a Mature Population.

The bilateral deficit (BLD) refers to the phenomenon where the sum of force from each leg is individually greater than the force produced of both legs simultaneously. Muscular strength is often measured in one limb and this tends to be stronger in the dominant leg, and the average or sum of strength in both legs is used for analysis. In many individuals, especially older populations, there can be a difference in muscular strength between each leg, which is termed the asymmetrical difference. There is a paucity of information regarding the asymmetrical difference on fall risk. PURPOSE: The purpose was to evaluate single leg strength and asymmetrical deficits relative to balance performance and fall risk in an active elderly population. METHODS: 7 male and 5 female (Age: 72.3 ± 5.8 yr, Height: 169.7 ± 11.2 cm, Body Mass: 77.2 ± 15.8 kg) volunteered to participate. Subjects were healthy, asymptomatic, ≥ 65 years and participated in exercise an average of twice per week (including resistance and cardiovascular exercise). Leg strength was assessed with a unilateral (UL) 12-RM single-leg (left & right) and a bilateral leg protocol (BL) on a variable resistance leg press machine and balance was assessed with both the Bilateral Comparison Test (BCT) and the Fall-Risk Screening Test (FRST) on the Biodex Balance System. Familiarization trials preceded testing by a minimum of 72 hrs. with balance tests performed first followed by strength tests. RESULTS: 5 participants displayed an asymmetrical difference (1.32 ± 1.8 kg), Pearson correlation statistical analysis revealed no significant relationship with overall balance performance (8.26±2.27 composite score, r = -0.151, p < 0.05) and no significant difference between right UL (1.24±0.36 overall sway, r = -0.174, p < 0.05) and left UL (1.34±0.60 overall sway, r = 0.405, p < 0.05). CONCLUSION: This small sample of active seniors failed to provide a significant correlation between an asymmetrical deficit and balance performance. An asymmetrical deficit does not appear to increase the chance of falls in older adults in this cohort. A larger sample size and a comparison to a sedentary population may provide additional insight.