Relationships between types of balance performance in 3-to-6-year-old preschoolers: a cross-sectional study

Balance is often considered task-specific, as indicated by studies correlating several types of balance performance across age groups. Preschool years constitute a critical period for balance development, yet comprehensive data during this stage remain limited. Therefore, this study aimed to (1) investigate the association between types of balance performance in preschool children and (2) examine age-specific aspects of balance performance in preschoolers.

Four balance types were assessed in 619 preschoolers (aged 3 to 6 years): static steady-state (one-legged stance, OST), dynamic steady-state (10-meter walk, 10MWT), proactive (functional reach test, FRT), and reactive (push and release test, PRT). Pearson's correlation coefficients (r) were calculated to determine associations between balance types, and a one-way analysis of variance was used to evaluate differences across age groups (3, 3.5, 4, 4.5, 5, and 5.5 years).

Small-sized correlations existed between four balance performance (-0.113 ≤ r ≤ 0.327, p < 0.01). Significant correlations were observed between static and dynamic steady-state balance (-0.207 ≤ r ≤ -0.359), static steady-state and proactive balance (+ 0.216 ≤ r ≤ + 0.510), and dynamic steady-state and proactive balance (-0.210 ≤ r ≤ -0.264) in most age groups. Age positively affected all balance tests: OST (η²_p = 0.336, p < 0.001), 10MWT (η²_p = 0.448, p < 0.001), FRT (η²_p = 0.392, p < 0.001), and PRT (η²_p = 0.045, p < 0.001).

Small-sized correlations suggest that balance performance is task-specific in preschool children. Balance ability improves gradually with age, showing different development patterns. These findings demonstrate that distinct balance types lack mutual predictability during early development. Therefore, comprehensive evaluation and enhancement of preschoolers' balance require separate assessment for each balance type and age-specific task design.