Responses indicating the presence of restlessness on the GAD-7 and ASRS-V1.1 do not always relate to worse standing balance performance

Purpose: This study aimed to determine if the similar symptoms of restlessness, fidgeting, and trouble relaxing between attention deficit hyperactivity disorder (ADHD) and generalized anxiety disorder (GAD) screening tools resulted in individuals having worse balance performance compared to individuals without these given symptoms. Methods: Forty undergraduate students (age: 20±1 years) from Western University completed the GAD-7 and ASRS-V1.1 and were allocated to ADHD (n=9; age: 21±1 years), anxiety (n=11; age: 21±1 years), control (n=17; age: 20±1 years), or combined ADHD and anxiety (n=3; age: 19±1 years) conditions. Balance was quantified via path length (PL) measurements of 20-second trials across four conditions: single (S) and double-leg (D) stances with eyes opened (EO) and closed (EC). Comparisons between PLs of different stances and across conditions were performed using one-way and two-way ANOVAs. Post-hoc tests were used to determine where the significance lay. Results: There was a significant difference in PL between conditions for the EOD stance (p=0.011); the combined condition had significantly longer PLs than all other conditions (control p=0.028; ADHD p=0.006; anxiety p=0.016). There was a statistically significant interaction between the mental health condition and their response to GAD-7 question 5 (Q5), “restlessness and unable to sit still” for PL in the EOS condition (p=0.009). Control individuals with “yes” responses to Q5 had a significantly longer PL versus “no” responses in the EOS stance (p=0.009; 179.19 cm±143.48 cm vs 77.51 cm±24.19 cm). The influence of the response to Q5 on PL in the ECD stance varied between conditions; “yes” was higher than “no” in the control condition (p=0.005; 36.38 cm±5.63 cm vs 26.47 cm±3.85 cm) but was lower in the anxiety condition (p=0.025; 24.63 cm±5.31 cm vs 33.32 cm±1.94 cm). Conclusion: Individuals with reported symptoms of “restlessness and unable to sit still” had longer PLs in the control condition for both the ECD and EOS conditions, but individuals with anxiety had shorter PLs in the ECD condition. Therefore, subjective symptomatology of mental health conditions has an inconsistent relationship to outcomes of balance testing. Measures of balance depend on the mental health condition an individual experiences.