Gender and age affect balance performance in primary school-aged children

Abstract

Objectives: Compromised stability may hinder a child's ability to master fundamental movement skills and, in turn, the capacity to participate in sporting activities. Therefore, the aim of this study was to investigate postural stability of primary school-aged children and to determine how this was moderated by age and gender. Design: Cross-sectional. Method: Static posturography of primary school-aged boys (n = 37) and girls (n = 47) was assessed while the children were standing feet apart, feet together and in single limb stances for 30 s. Results: The boys displayed greater sway than the girls for all conditions, although only the single limb stance scores were significantly different between the two groups (boys: 632 ± 323 mm; girls: 456 ± 338 mm; p = 0.04). Eight-year-old children displayed significantly greater sway than the older children during the two dual limb stance conditions, whereas the 8-year-old children performed significantly poorer during the single limb condition than the 10-year-old children. Conclusions: This study shows that when postural stability was challenged, boys displayed greater postural sway than girls and, although proficiency in performing dual limb balance tasks appeared achievable by the time children are 9-years of age; the more difficult single limb balance task required a further 12 months to develop. As balance is important for movement skill development and injury prevention, care should be taken to ensure movement tasks are appropriately designed for boys and girls of different ages.

Introduction

Balance is the ability to stabilise the body in order to maintain posture during both static and dynamic situations.¹ The process of balance relies on integrating information from the visual, vestibular and proprioceptive systems in order to elicit appropriate muscular responses to produce postural adjustments so that the body's centre of gravity is maintained over its base of support.² The ability to maintain postural stability is an essential pre-requisite to competently perform most activities of daily living, and important for proficient performance of fundamental movement skills. The most significant transitions in motor development occur in the first decade of life with balance control usually established between the ages of 7–10 years.3, 4 For children, proficiency in postural control develops not only as they increase in age but also from interacting with their environment and through fine tuning of muscular torques during growth and development.3, 5 However, if the ability to balance is not mastered in the early years of life, it can potentially reduce the efficiency of performing more complicated movement skills, such as running and jumping, and may increase the likelihood of a child sustaining an injury during sports participation.6, 7

Despite the importance of balance in the development of fundamental movement skills, very few studies have investigated postural stability in otherwise healthy children. Postural stability has been investigated in various adult populations, such as athletes,⁸ healthy adults,9, 10 adults with pathologies1, 11, 12 and the elderly,13, 14, 15 traditionally examined by spatial measures of the centre of pressure.¹⁶ However, of the limited studies examining balance in children, many of these studies have focussed on children with pathologies,4, 17, 18 or have been restricted to the use of a laboratory-based force platform to measure balance or postural stability.16, 19 Field-based methods to measure balance and postural stability are particularly important when assessing children to allow this to occur in more authentic and accessible community venues such as schools. Despite this, few studies have examined both static and dynamic balance in healthy children using field-based assessments, or have reported only fair-to-moderate reliability for a system (Balance Master)²⁰ not easily available to community/clinical settings. Therefore, the aim of this study was to investigate the static and dynamic postural stability of primary school-aged children and to determine whether this was moderated by age and/or gender. It was hypothesised that gender differences may exist due to earlier maturation of the neurological, visual, vestibular and proprioceptive systems in girls and that postural stability would improve with age.²¹ Determining these gender and age differences in postural stability is important for many practical fields such as physical education and youth sport.