This resource was developed by bpac
nz
for the Health Quality & Safety Commission based on the STEADI falls campaign by the US Centres for Diseases Control and Prevention (CDC).
Patient name: Date: Time: AM/PM
NHI: Test carried out by:
The Four Stage Balance Test
Overview: The Four-Stage Balance Test, in conjunction with other measures such as the 30 Second
Chair Stand Test and Timed Up and Go (TUG) Test and an assessment of postural
hypotension can help to indicate if a patient is at risk of falling.
Purpose: To assess static balance
Equipment: A stopwatch
Directions: Patients are asked to perform four progressively more challenging positions. Patients
should not use an assistive device (e.g. walking stick), and should keep their eyes open.
If you feel the patient may be unstable and at a high risk of falling, or you are unable to safely catch them, you
may choose to avoid this test.
Instructions to the patient:
“I’m going to show you four positions.
Try to stand in each position for ten seconds. You can hold your arms out or move your body to help keep your balance
but don’t move your feet. Hold this position until I tell you to stop.
Describe and demonstrate each position. Stand next to the patient, hold their arm and help them assume the correct
foot position.
When the patient is steady, let go, but be ready to catch them if they lose their balance.
For each stage, say Ready, begin and begin timing.
After 10 seconds, say Stop.”
If the patient can hold the position for ten seconds without moving their feet or needing support, proceed to the next
position.
If not, stop the test.
See over page for detailed patient instructions and illustrations of the four positions.
ASSESS
This resource was developed by bpac
nz
for the Health Quality & Safety Commission based on the STEADI falls campaign by the US Centres for Diseases Control and Prevention (CDC).
1. Parallel stance
Stand with your feet side by side. Time:
2. Semi-tandem stance
Place the instep of one foot so it is touching the big toe
of the other foot.
Time:
3. Tandem (Heel-Toe) stance
Place one foot in front of the other, heel touching toe. Time:
4. One-legged stance
Stand on one foot. Time:
Patients aged 65 years or older who do not progress to the tandem (heel-toe) stance or cannot hold
this stance for at least ten seconds are at increased risk of falling.
Notes:
Reference: Rossiter-Forno J, Walf S, Wolfson L. A cross-sectional validation study of the FICSIT common data base static balance measures. Gerontol
A Biol Sci Med Sci 1995;50A(6):M291-M297.
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