Weight-Bearing Ankle Dorsiflexion in Older Adults with and Without a History of Falls: A Cross-Sectional Study of Associations with Balance, Functional Mobility, and Concern About Falling

Background: Weight-bearing ankle dorsiflexion may be relevant to postural control and mobility, but its relationship with fall history in older adults remains insufficiently examined. This study compared weight-bearing ankle dorsiflexion between older adults with and without a history of falls and examined associations with balance, functional mobility, concern about falling, and faller status. Materials and Methods: This cross-sectional study included 90 community-dwelling older adults (mean age 72.6 ± 5.4 years; 62.2% women), comprising 45 fallers and 45 non-fallers classified by self-reported fall history during the previous 12 months. Weight-bearing ankle dorsiflexion was assessed using the weight-bearing lunge test (WBLT); balance, mobility, and concern about falling were assessed using Frailty and Injuries: Cooperative Studies of Intervention Techniques (FICSIT-4), Timed Up and Go (TUG), and the Greek Falls Efficacy Scale-International (FES-I). Results: Fallers had lower bilateral mean WBLT values than non-fallers (7.1 ± 2.0 vs. 9.4 ± 2.1 cm, p < 0.001). Greater bilateral mean WBLT distance was associated with higher FICSIT-4 scores (r = 0.47), shorter TUG times (r = −0.52), and lower FES-I scores (r = −0.44; all p < 0.001). Bilateral mean WBLT distance was associated with lower odds of faller status after adjustment for age, sex, and body mass index (OR = 0.56, 95% CI 0.42–0.73, p < 0.001), remaining significant after additional adjustment for medication count (OR = 0.54, 95% CI 0.40–0.72, p < 0.001). In an exploratory within-sample ROC analysis without independent validation, WBLT bilateral mean distance discriminated previous faller status (AUC = 0.79, 95% CI 0.69–0.88), but did not establish prediction of future falls. Conclusions: Older adults with a history of falls demonstrated reduced weight-bearing ankle dorsiflexion. The WBLT may provide complementary ankle-specific information associated with faller status and fall-related functional characteristics. Longitudinal studies are needed to determine its prognostic value for future falls.