4-Stage Balance Test: check your fall risk at home
The 4-Stage Balance Test, from the CDC, has you hold four standing positions that get harder, for 10 seconds each: feet side by side, one foot slightly ahead, one foot directly in front of the other, and one foot. If you can’t hold the third position, heel to toe, for 10 seconds, the CDC considers you at increased risk of falling.1
Check your result
After the test, choose the last position you held for 10 seconds without moving your feet or holding on. Your result appears below. Nothing you choose leaves this page.
Choose the last position you held to see what your result means.
How to do the test
You need a timer and a helper to stand next to you. Stand beside a kitchen counter or sturdy chair, keep your eyes open and don’t use a cane or walker. Each position is a little harder than the one before.1
- Position 1Feet side by side
- Position 2Instep to big toe
- Position 3Heel to toe (tandem stand)
- Position 4One foot
Step 1: Stand with your feet side by side. Hold for 10 seconds.
Step 2: Move one foot forward so the instep of that foot touches the big toe of the other foot. Hold for 10 seconds.
Step 3: Place one foot directly in front of the other, heel touching toe. Hold for 10 seconds.
Step 4: Stand on one foot. Hold for 10 seconds.
Step 5: You can hold your arms out or move your body to keep your balance, but don’t move your feet. If you move your feet or need support before 10 seconds, stop there: that position is where your test ends.
Safety first
- Have your helper stand next to you and hold your arm while you get into each position, then let go once you’re steady and stay ready to help.1
- Stand within reach of a counter or sturdy chair, and clear the floor of rugs, cords and pets.
- If you’ve fallen recently or feel very unsteady, ask your doctor or a physical therapist to test you.
- Stop if you feel dizzy or lightheaded.
Doing more than one test? Print our free score sheet to record your results and compare them with the norms for your age, or download it as a PDF.
How the 4-Stage Balance Test is scored
There are no age norms for this test. What matters is the last position you can hold for 10 seconds without moving your feet or holding on.1
| Position | How to stand | If you can’t hold it |
|---|---|---|
| 1. Feet side by side | Stand with your feet side by side. | Increased risk of falling |
| 2. Instep to big toe | Move one foot forward so the instep of that foot touches the big toe of the other foot. | Increased risk of falling |
| 3. Heel to toe (tandem stand) | Place one foot directly in front of the other, heel touching toe. | Increased risk of falling |
| 4. One foot | Stand on one foot. | Stop here; practice standing on one foot |
What your result means
You couldn’t hold position 3 for 10 seconds
The CDC considers this a sign of increased fall risk, and suggests physical therapy for walking and balance exercises, or an evidence-based fall prevention program such as tai chi.1 Tell your doctor about your result. Balance responds to practice at any age.
You held position 3 or 4
You cleared the CDC’s fall-risk mark. If you held all four, the single-leg balance test times you for up to 30 seconds and compares your time with others your age. Either way, a few minutes of balance practice most days keeps it that way.
One test is a snapshot, not the whole picture. At a free TogetherWON consultation, a trainer looks at balance alongside strength, walking and endurance, then builds a plan around your goals.
4-Stage Balance Test questions
What does it mean if I can’t hold the tandem stance for 10 seconds?
The CDC considers an older adult who can’t hold the heel-to-toe tandem stand for 10 seconds to be at increased risk of falling.
It suggests physical therapy for walking and balance exercises, or an evidence-based fall prevention program such as tai chi. It is not a diagnosis, but it is worth telling your doctor about.
How fall prevention training worksCan I hold on to something during the 4-Stage Balance Test?
Only while you get into position. Your helper can hold your arm while you set your feet, then lets go once you’re steady and starts the timer. Don’t use a cane or walker during the test.
You can hold your arms out or sway your body to keep your balance, as long as your feet don’t move.
How is the 4-Stage Balance Test different from the single-leg balance test?
The 4-Stage test works up to standing on one foot and checks whether you can hold each position for 10 seconds. The single-leg balance test times how long you can stand on one foot, up to 30 seconds, and compares your time with norms for your age.
If you can hold all four stages, the single-leg test tells you more.
Take the single-leg balance testHow can I improve my balance for the 4-Stage test?
Practice the positions at a kitchen counter, with a hand ready to hold on: feet together, then one foot slightly ahead, then heel to toe, then one foot. Build up to 10 seconds and beyond. Strength work for your legs and hips helps too.
Retest every four to eight weeks.
Read our balance exercises guideSources
- Centers for Disease Control and Prevention. STEADI Assessment: The 4-Stage Balance Test. 2017. View source
This test is for education and self-tracking. It is not a medical diagnosis and doesn’t replace advice from your doctor or physical therapist.
Want an expert to check your balance?
Your first session is free: a one-hour consultation and movement assessment, in your home in the Colorado Springs area or online, where we test strength and balance and build a plan that fits your life.