# Examining Balance and the Likelihood of Falls in Huntington’s Disease

## TL;DR

This study shows that a balance test called TBS is effective at identifying Huntington’s disease patients at risk of falling, which can help prevent nursing home placement.

## Contribution

The study introduces TBS as a novel and effective clinical tool for fall risk assessment in Huntington’s disease.

## Key findings

- TBS significantly outperformed TUG and CST in distinguishing fallers from non-fallers in HD patients.
- TBS had a high diagnostic utility with a likelihood ratio of 5.06 for identifying fallers.
- CST showed no significant ability to differentiate between fallers and non-fallers.

## Abstract

Balance impairment may begin prior to motor diagnosis in Huntington’s disease (HD) and is associated with an increased risk of falls—an important predictor of nursing home placement.

To evaluate the ability of three balance measures to discriminate between Fallers and Non-Fallers and to estimate the likelihood of falling in HD patients.

125 gene-positive individuals were stratified into Fallers (n = 30) and Non-Fallers (n = 95) based on fall history. Participants completed a Total Body Sway (TBS) assessment using the BTrackS™ Balance Plate, Timed Up-and-Go (TUG), and Chair Sit-to-Stand Test (CST). Group differences were analyzed with Mann–Whitney U test. ROC curve analysis was used to calculate likelihood ratios (LRs) for each assessment’s ability to distinguish Fallers from Non-Fallers.

Fallers demonstrated significantly higher TBS scores compared to Non-Fallers (p < 0.001), while differences on TUG (p = 0.098) and CST (p = 1.00) were not significant. TBS yielded the highest area under the curve (AUC = 0.89, p < 0.001), followed by TUG (AUC = 0.66, p = 0.008), while CST did not discriminate between groups (AUC = 0.47, p = 0.617). TBS also demonstrated superior diagnostic utility (LR+ = 5.06; LR– = 0.24) compared to TUG (LR+ = 3.41; LR– = 0.62) and CST (LR+ = 1.59; LR– = 0.90).

TBS and, to a lesser extent, TUG are valid tools for identifying individuals at risk of falling in HD. In contrast, the CST may not be an effective clinical measure in this regard.