Background Slacklining academic research span less than 15 years. An in-depth scoping review would improve evidence for or against slacklining in falls prevention and identify the concepts, theories, sources, and knowledge gaps.

Methods A scoping review used internet Search-engines and databases for any publications from inception till January 2022, including grey-literature by hand-search or expanded through scientific/social-networking sites. Data selection used a modified Arksey and O’Malley framework. Inclusion criteria were key search-terms associated with ‘slacklin* or slackl-lin* that referenced human falls and injury prevention in English, German, Spanish, Portuguese, and French. Further reduction used ‘Not’ elimination, then independent extraction based on title/abstract by two reviewers, discrepancies ratified by a third. All articles were mapped falls relevant for subject-grouping.

Results From 7158 articles 29 were identified, five grey-literature; 12 RCTs PEDro scored average=5.7. Evidence included: Level-I=six systematic reviews (three slackline-specific, three included slacklining); Level-II=11 (RCTs); Level-III=1 (CCT); Level-IV=4 (cohort-studies); Level-V=0 (qualitative-studies); Level-VI=4 (descriptive-studies/case-studies); Level-VII=3 (opinion-articles). Neurological patients=6.

Conclusions Slackline research has progressed significantly in the decade of publication. However, investigations of effectiveness for falls management and prevention, particularly with symptomatic patients remains deficient with most symptomatic research being Level I and II in neurological patients then falls and sports-injury prevention.

Learning Outcomes slacklining has a strong role in falls prevention and rehabilitation as a highly adaptable balance challenge task that is self-motivating and self-directed for musculoskeletal, neurological and sporting subjects from children to seniors and elite athletes.