Supplementary Material for: Age-Related Differences in Quality of Standing Balance Using a Composite Score

Background: Age-related differences in standing balance are not detected by testing the ability to maintain balance. Quality of standing balance might be more sensitive to detect age-related differences. Objective: To study age-related differences in quality of standing balance, center of pressure (CoP) movement was evaluated using a wide range of CoP parameters in several standing conditions in healthy young and old participants. Methods: In 35 healthy young (18-30 years) and 75 healthy old (70-80 years) participants, CoP movement was assessed in eight standing conditions on a force plate, including side-by-side, one-leg, semi-tandem and tandem stance, both with eyes open and eyes closed. Direction-specific CoP composite scores were calculated from standardized single CoP parameters (mean amplitude, amplitude variability, mean velocity, velocity variability and range) in anterior-posterior (AP) and medial-lateral (ML) direction. Linear regression analysis was used to detect age-related differences in single CoP parameters and composite scores - adjusted for gender, height and weight. Results: Overall, single CoP parameters were higher in old compared to young participants, but no single CoP parameter consistently demonstrated the largest effect size for all standing conditions. Age-related differences were demonstrated for CoP composite scores in AP direction (tandem eyes open; semi-tandem eyes closed; p < 0.001). CoP composite scores in ML direction were consistently higher for all standing conditions in old compared to young participants (p < 0.001). Conclusion: CoP composite scores in ML direction were the most consistent parameters to detect age-related differences in quality of standing balance in healthy participants and might be of clinical value to detect subtle changes in quality of standing balance.