European Journal of Applied Physiology

, Volume 111, Issue 11, pp 2805–2812 | Cite as

Golfers have better balance control and confidence than healthy controls

  • Kelly L. Gao
  • Christina W. Y. Hui-Chan
  • William W. N. TsangEmail author
Original Article


In a well-executed golf swing, golfers must maintain good balance and precise control of posture. Golfing also requires prolonged walking over uneven ground such as a hilly course. Therefore, repeated golf practice may enhance balance control and confidence in the golfers. The objective is to investigate whether older golfers had better balance control and confidence than non-golfing older, healthy adults. This is a cross-sectional study, conducted at a University-based rehabilitation center. Eleven golfers and 12 control subjects (all male; mean age: 66.2 ± 6.8 and 71.3 ± 6.6 years, respectively) were recruited. Two balance control tests were administered: (1) functional reach test which measured subjects’ maximum forward distance in standing; (2) sensory organization test (SOT) which examined subjects’ abilities to use somatosensory, visual, and vestibular inputs to control body sway during stance. The modified Activities-specific Balance Confidence (ABC) determined subject’s balance confidence in daily activities. The golfers were found to achieve significantly longer distance in the functional reach test than controls. They manifested significantly better balance than controls in the visual ratio and vestibular ratio, but not the somatosensory ratio of the SOT. The golfers also reported significantly higher balance confidence score ratios. Furthermore, older adults’ modified ABC score ratios showed positive correlations with functional reach, visual and vestibular ratios, but not with somatosensory ratio. Golfing is an activity which may enhance both the physical and psychological aspects of balance control. Significant correlations between these measures reveal the importance of the balance control under reduced or conflicting sensory conditions in older adults’ balance confidence in their daily activities. Since cause-and-effect could not be established in the present cross-sectional study, further prospective intervention design is warranted.


Aging Golfing Falls Balance Confidence 



The authors thank the Hong Kong Polytechnic University for financial support of this study through an Area of Strategic Development Grant to C.W.Y. Hui-Chan, W.W.N. Tsang et al. Thanks are also owed to the subjects and to the older adult centers for permission to recruit their members. The authors also thank Mr. Bill Purves for his English editorial advice. No commercial party having a direct financial interest in the research findings reported here has conferred or will confer a benefit on the authors or on any organization with which the authors are associated.


  1. Agrawal Y, Carey JP, Della Santina CC, Schubert MC, Minor LB (2009) Disorders of balance and vestibular function in US Adults: data from the National Health and Nutrition Examination Survey, 2001–2004. Arch Intern Med 169(10):938–944PubMedCrossRefGoogle Scholar
  2. Aslan UB, Cavlak U, Yagci N, Akdag B (2008) Balance performance, aging and falling: a comparative study based on a Turkish sample. Arch Gerontol Geriatr 46(3):283–292PubMedCrossRefGoogle Scholar
  3. Berg KO, Kairy D (2002) Balance interventions to prevent falls. Generations (San Francisco, Calif.) 26:75–78Google Scholar
  4. Buatois S, Gueguen R, Gauchard GC, Benetos A, Perrin PP (2006) Posturography and risk of recurrent falls in healthy non-institutionalized persons aged over 65. Gerontology 52(6):345–352PubMedCrossRefGoogle Scholar
  5. Campbell AJ, Spears GF, Borrie MJ (1990) Examination by logistic-regression modeling of the variables which increase the relative risk of elderly women falling compared to elderly men. J Clin Epidemiol 43(12):1415–1420PubMedCrossRefGoogle Scholar
  6. Carpenter MG, Adkin AL, Brawley LR, Frank JS (2006) Postural, physiological and psychological reactions to challenging balance: Does age make a difference? Age Ageing 35(3):298–303PubMedCrossRefGoogle Scholar
  7. Carter ND, Kannus P, Khan KM (2001) Exercise in the prevention of falls in older people—a systematic literature review examining the rationale and the evidence. Sports Med 31(6):427–438PubMedCrossRefGoogle Scholar
  8. Chiu HFK, Lee HC, Chung WS, Kwong PK (1994) Reliability and validity of the cantonese version of mini-mental status examination: a preliminary study. Hong Kong J Psychiatry 4(2):25–28Google Scholar
  9. Chu LW, Chi I, Chiu AY (2005) Incidence and predictors of falls in the Chinese elderly. Ann Acad Med Singap 34(1):60–72PubMedGoogle Scholar
  10. Dennis RJ (1999) Functional reach improvement in normal older women after Alexander Technique instruction. J Gerontol Ser A Biol Sci Med Sci 54(1):M8–M11CrossRefGoogle Scholar
  11. Dietz V, Schubert M, Discher M, Trippel M (1994) Influence of visuoproprioceptive mismatch on postural adjustments. Gait Posture 2:147–155CrossRefGoogle Scholar
  12. Dietz V, Trippel M, Horstmann GA (1991) Significance of proprioceptive and vestibulospinal reflexes in the control of stance and gait. In: Patla AE (ed) Adaptability of human gait. Elsevier, Amsterdam, pp 37–52CrossRefGoogle Scholar
  13. Draovitch P, Westcott W (1999) Complete conditioning for golf. Human Kinetics, ChampaignGoogle Scholar
  14. Duncan PW, Weiner DK, Chandler J, Studenski S (1990) Functional reach—a new clinical measure of balance. J Gerontol 45(6):M192–M197PubMedGoogle Scholar
  15. Hegeman J, van den Bemt BJF, Duysens J, van Limbeek J (2009) NSAIDs and the risk of accidental falls in the elderly: a systematic review. Drug Saf 32(6):489–498PubMedCrossRefGoogle Scholar
  16. Huang HC, Gau ML, Lin WC, Kernohan G (2003) Assessing risk of falling in older adults. Public Health Nurs 20(5):399–411PubMedCrossRefGoogle Scholar
  17. Ko YM, Park WB, Lim JY, Kim KW, Paik NJ (2009) Discrepancies between balance confidence and physical performance among community-dwelling Korean elders: a population-based study. Int Psychogeriatr 21(4):738–747PubMedCrossRefGoogle Scholar
  18. Lajoie Y, Gallagher SP (2004) Predicting falls within the elderly community: comparison of postural sway, reaction time, the Berg balance scale and the Activities-specific Balance Confidence (ABC) scale for comparing fallers and non-fallers. Arch Gerontol Geriatr 38(1):11–26PubMedCrossRefGoogle Scholar
  19. Lee DN, Lishman R (1975) Visual proprioceptive control of stance. J Hum Mov Stud 1:87–95Google Scholar
  20. Leong HT, Fu SN, Ng GYF, Tsang WWN (2011). Low level Taekwondo practitioners have better somatosensory organisation in standing balance than normal sedentary people. Eur J Appl Physiol. doi: 10.1007/s00421-00010-01798-00427
  21. Nashner LM (1994) Evaluation of postural stability, movement and control. In: Hasson SM (ed) Clinical exercise physiology. Mosby, St. Louis, pp 199–234Google Scholar
  22. Okuda I, Armstrong CW, Tsunezumi H, Yoshiike H (2002) Biomechanical analysis of professional golfer’s swing: Hidemichi Tanaka. In: Thain E (ed) Science and golf IV. Routledge, London, pp 18–27Google Scholar
  23. Powell LE, Myers AM (1995) The Activities-specific Balance Confidence (ABC) Scale. J Gerontol Ser A Biol Sci Med Sci 50(1):M28–M34CrossRefGoogle Scholar
  24. Rubenstein LZ, Josephson KR (2002) The epidemiology of falls and syncope. Clin Geriatr Med 18(2):141–158PubMedCrossRefGoogle Scholar
  25. Sell TC, Tsai YS, Smoliga JM, Myers JB, Lephart SM (2007) Strength, flexibility, and balance characteristics of highly proficient golfers. J Strength Cond Res 21(4):1166–1171PubMedGoogle Scholar
  26. Shumway-Cook A, Ciol MA, Gruber W, Robinson C (2005) Incidence of and risk factors for falls following hip fracture in community-dwelling older adults. Phys Ther 85(7):648–655PubMedGoogle Scholar
  27. Steinman BA, Pynoos J, Nguyen AQD (2009) Fall risk in older adults roles of self-rated vision, home modifications, and limb function. J Aging Health 21(5):655–676PubMedCrossRefGoogle Scholar
  28. Sundermier L, Woollacott MH, Jensen JL, Moore S (1996) Postural sensitivity to visual flow in aging adults with and without balance problems. J Gerontol Ser A Biol Sci Med Sci 51(2):M45–M52CrossRefGoogle Scholar
  29. Tinetti ME, Gordon C, Sogolow E, Lapin P, Bradley EH (2006) Fall-risk evaluation and management: challenges in adopting geriatric care practices. Gerontologist 46(6):717–725PubMedCrossRefGoogle Scholar
  30. Tsang WWN, Hui-Chan CW (2010) Static and dynamic balance control in older golfers. J Aging Phys 18:1–13Google Scholar
  31. Tsang WWN, Hui-Chan CWY (2003) Effects of Tai Chi on joint proprioception and stability limits in elderly subjects. Med Sci Sports Exerc 35(12):1962–1971PubMedCrossRefGoogle Scholar
  32. Tsang WWN, Hui-Chan CWY (2004) Effects of exercise on joint sense and balance in elderly men: Tai Chi versus golf. Med Sci Sports Exerc 36(4):658–667PubMedCrossRefGoogle Scholar
  33. Tsang WWN, Hui-Chan CWY (2005) Comparison of muscle torque, balance, and confidence in older Tai Chi and healthy adults. Med Sci Sports Exerc 37(2):280–289PubMedCrossRefGoogle Scholar
  34. Tsang WWN, Wong VS, Fu SN, Hui-Chan CW (2004) Tai Chi improves standing balance control under reduced or conflicting sensory conditions. Arch Phys Med Rehabil 85(1):129–137PubMedCrossRefGoogle Scholar
  35. Van Heuvelen MJG, Kempen G, Ormel J, Rispens P (1998) Physical fitness related to age and physical activity in older persons. Med Sci Sports Exerc 30(3):434–441PubMedGoogle Scholar
  36. Wallmann HW (2001) Comparison of elderly nonfallers and fallers on performance measures of functional reach, sensory organization, and limits of stability. J Gerontol Ser A Biol Sci Med Sci 56(9):M580–M583CrossRefGoogle Scholar
  37. Woollacott MH, Shumway-cook A, Nashner LM (1986) Aging and posture control—changes in sensory organization and muscular coordination. Int J Aging Hum Dev 23(2):97–114PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Kelly L. Gao
    • 1
  • Christina W. Y. Hui-Chan
    • 2
  • William W. N. Tsang
    • 1
    Email author
  1. 1.Department of Rehabilitation SciencesThe Hong Kong Polytechnic UniversityKowloonHong Kong
  2. 2.Department of Physical TherapyUniversity of Illinois at ChicagoChicagoUSA

Personalised recommendations