Test circumstances (e.g., room illumination, temperature, noise) during balance assessment were in accordance with recommendations for posturographic testing [24]. Static steady-state balance was assessed using the Romberg Test [24]. Participants performed four tasks with an increasing level of difficulty: (1) standing in an upright position with feet closed and eyes opened for 10 s without swaying while holding both arms extended in horizontal direction with palms facing upwards; (2) ditto, but with eyes closed; (3) ditto, but eyes opened and feet in tandem stance; (4) ditto, but eyes closed and feet in tandem stance. Standing time during the different test conditions was recorded using a stopwatch to the nearest 0.1 s. Maximal stance time for the fourth task was used for further analysis. Age-specific corresponding norm values are 14.0 to 15.0 s for females and 14.3 to 17.5 s for males [24]. High test-retest reliability has been shown for the Romberg Test (eyes opened, intraclass correlation coefficient [ICC] = 0.86 and eyes closed, ICC = 0.84) and Sharpened Romberg Test (eyes opened, ICC = 0.70 and eyes closed, ICC = 0.91) [25].

Dynamic steady-state balance was assessed using the 10-m walking test. Participants walked with their own footwear at self-selected speeds, initiating and terminating each walk a minimum of one meter before and after the 10-m walkway to allow sufficient distance to accelerate to and decelerate from a steady state of ambulation across the walkway. Time was recorded with a stopwatch to the nearest 0.1 s. Gait speed (m/s) was determined from the time needed to cover the 10-m walking distance under single-task (walking only) and dual-task conditions (walking while concurrently performing a cognitive interference task or a motor interference task). Age-specific norm values for single-task gait speed are 1.10 m/s for females and 1.12 m/s for males [26].

Proactive balance was assessed using the TUG and the FRT. The TUG was used as described by Podsiadlo and Richardson [27]. Participants were asked to perform the TUG at their self-selected habitual walking speed. Time was recorded with a stopwatch to the nearest 0.1 s. Participants were seated and instructed to walk three meters, turn around, walk back to the chair and sit down. The stopwatch was started on the command “ready-set-go” and stopped as the participant sat down. Age-specific corresponding norm values are 8.0 to 9.0 s for both sexes [28]. The TUG showed excellent test-retest reliability (ICC = 0.99) in older adults [27]. Proactive balance was further assessed by means of the FRT. The FRT measures the maximal distance one can reach forward beyond arm’s length while maintaining a fixed base of support in the standing position [29]. Maximal reach distance of the right arm was recorded to the nearest 0.5 cm. Age-specific norm values are 29.0 to 30.0 cm for both sexes [30]. The FRT showed excellent test-retest reliability (ICC = 0.92) in older adults [29]. Validity of the FRT has previously been shown by Newton et al. [31] when testing healthy community-dwelling older adults.

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