This calculator is for general information and education. It is not medical advice and does not replace the judgment of a doctor, nurse or pharmacist who knows the full clinical picture.
The 4-stage balance test is a quick check of static balance used in the CDC STEADI fall-prevention toolkit. The person tries to hold four progressively harder stances for 10 seconds each, without moving their feet or holding on.
The four stances
- Feet side by side, touching.
- Semi-tandem: the instep of one foot touches the big toe of the other.
- Tandem: one foot directly in front of the other, heel touching toe.
- Standing on one foot.
How to do the test safely
- Stand next to the person, ready to steady them, near a wall or a sturdy counter.
- Demonstrate each stance, then let them choose which foot goes in front.
- Time each stance for up to 10 seconds. Move on to the next stance only if they held the previous one for 10 seconds.
- Stop as soon as they move their feet, reach for support or lose balance.
Example
Someone holds the first two stances for 10 seconds each, the tandem stance for 8 seconds and stands on one foot for 3 seconds. They held two stages for 10 seconds, and because they could not hold the tandem stance, their risk of falls is higher.
What the result means
| Result | Meaning |
|---|---|
| tandem stance not held for 10 s | increased risk of falls (CDC STEADI) |
| tandem held, one-foot stance under 10 s | common with age; work on balance |
| all four stances held for 10 s | good static balance |
Several studies have linked standing on one leg for less than 5 seconds with a higher risk of injurious falls in older adults, and an inability to stand on one leg for 10 seconds in middle age with poorer health outcomes.
Improving balance
Balance can be trained at any age. Practice the stances near a counter, holding on at first and then letting go; walk heel to toe along a hallway; and try tai chi or a structured program such as Otago, which reduces falls. Strength exercises for the legs and good footwear help as well.
This test checks only one part of balance. A full assessment also looks at walking, turning, vision, medicines and blood pressure.