Ankle Proprioception, Dual-Task Balance Performance, and Ageing: A Cross-Sectional Study

Balance is reliant on key sensory information to maintain postural control. Proprioception is one of the key sensory inputs that influence postural control during static balance tasks. Poor proprioception can lead to impaired balance, which may be amplified under dual-task balance conditions. This study investigates this relationship between proprioception and dual-task balance performance and how it may be affected by age. Proprioception was measured for each ankle using Active Movement Extent Discrimination Assessment (AMEDA), a protocol which determines ankle kinaesthesia acuity through active, weight-bearing ankle inversion movements. Participants completed 12 static dual-task balance conditions (feet together, tandem stance) paired with a cognitive task (control task, digit span forward, and backward). Balance performance was measured by centre of pressure trajectories. Relationships between ankle kinaesthesia and dual-task balance were analysed with linear mixed effects models accounting for age, balance condition and cognitive task. Thirty participants (mean age 52.4, SD 16.4) were recruited. Mixed effects models showed significantly greater sway with tandem foot position (compared to feet together, p < .001) in all models. Higher AMEDA score was associated with lower body sway area (p = .025). AMEDA score was not related to mediolateral or anteroposterior sway range. Older age was associated with greater maximum sway range in the mediolateral (p = .019) and anteroposterior directions (p = .032) and approached significance for body sway area (p = .058). Superior mean ankle kinaesthesia is associated with less body sway area under dual-task conditions, while older age is associated with a greater sway range. Findings suggest proprioception influences dual-task balance performance, such that the ability to control body sway is greater when ankle kinaesthesia is greater. Future studies should consider incorporating single leg stance under dual-task conditions to investigate if the influence of proprioception varies for individual ankle kinaesthesia and limb dominance.