BackgroundHiking at moderate altitude is a popular outdoor activity in seniors. Acute exercise or altitude can diminish balance performance. Thus, the present study examined the combined effects of altitude and walking on static and dynamic balance. MethodsThirty-six healthy seniors (age: 62 (SD: 4) y; BMI: 25 (5) kg/m2) were examined on three days. Firstly, walking velocity was determined at 85% of the first ventilatory threshold (VT1). Therefore, a ramp walking test on a treadmill was completed. On day two or three, a 40-minute treadmill walk under sea level or normobaric hypoxia (2600m) was performed using a random, double-blind study design. Balance performance was assessed on a force-plate during single leg stance with eyes open (SLEO, 10s on a force-plate) immediately before and after walking. Spatio-temporal gait characteristics were collected during walking at 5 and 35min. ResultsCondition×time interaction effects were not found for either parameter (0.13<p<0.60; 0.007<ηp2<0.07). Only time effects were observed for cadence (−1.5%, p<0.001, ηp2=0.29), stride time (+2.3%, p=0.007, ηp2=0.28), and temporal gait variability (+22.6%, p=0.01, ηp2=0.16). A moderate time×condition effect was observed for postural sway during SLEO (p=0.04, ηp2=0.11). Subseqent post hoc testing revealed difference between hypoxia and normoxia at 35min (p=0.01) and between 5 and 35min testing during hypoxia and normoxia (both p<0.001). ConclusionAlterations of cadence, stride time, and temporal gait variability might be attributed to fatigue-induced changes of temporal gait adjustments. Normobaric hypoxia did not acutely impair gait patterns. We assume that demanding postural standing tasks that require more central control may be affected to a greater extent by altitude exposure.