ASSESSMENT
The 4-Stage Balance Test
Purpose: To assess static balance Equipment: A stopwatch
Directions: There are four standing positions that
get progressively harder to maintain. You should describe and demonstrate each position to the patient. Then, stand next to the patient, hold their arm, and help them assume the correct position. When the patient is steady, let go, and time how long they can maintain the position, but remain ready to assist the patient if they should lose their balance.
If the patient can hold a position for 10 seconds without moving their feet or needing support, go on to the
next position.
If not, STOP the test.
Patients should not use an assistive device (cane or walker)
and they should keep their eyes open.
An older adult who cannot hold the tandem stand for at least 10 seconds is at increased risk of falling. To reduce their risk of falling, you might consider referring them to physical therapy for gait and balance exercises, or refer them to an evidence-based fall prevention program, such as Tai Chi.