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Printed on 7/20/2026
For informational purposes only. This is not medical advice.
The Single-Leg Stance Test measures how long a person can stand on one leg without support. It is a practical bedside/outpatient balance screen used in older-adult assessment and rehabilitation to identify postural instability and track progress.
Formula: Result is the best unsupported single-leg stance duration in seconds.
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Have the patient stand on a firm, flat surface near a wall or rail for safety. The patient should be wearing their usual footwear (standardize footwear across serial assessments). Instruct the patient to stand on one leg — starting with their preferred/dominant leg — without holding onto anything or touching the raised leg to the standing leg. The non-weight-bearing foot can be raised to any comfortable height. Arms may be held at the sides or crossed over the chest but must not be used for balance or wall contact. Demonstrate the correct position and have the examiner stand adjacent for safety.
Start timing when the non-weight-bearing foot leaves the floor. Stop timing when any of the following occur: the raised foot touches the floor; the raised foot touches or rests against the standing leg; the standing foot shifts or hops; arms reach for support; or 30-60 seconds is reached (maximum time). Perform 3 trials on each leg and record the best time for each. Repeat on the opposite leg. The stance time on the weaker leg is typically more clinically informative than the dominant leg result. Document whether timing was stopped by test failure or maximum time reached.
Apply age-based thresholds: adults 60-69 should typically achieve above 20 seconds; adults 70-79 should typically achieve above 10 seconds; adults 80 and older should typically achieve above 5 seconds. In older adults aged 70 and above, a single-leg stance time below 5 seconds is associated with significantly elevated fall risk and should trigger comprehensive falls assessment. Below 10 seconds in adults 70+ warrants clinical attention. Serial measurements at 6-8 week intervals document response to balance training interventions, vestibular rehabilitation, or lower extremity strengthening programs.
Primary care physicians, geriatricians, NPs
The single-leg stance test requires no equipment and takes under 2 minutes, making it ideal for annual fall-risk screening at primary care wellness visits for adults 65 and older. A stance time below 5 seconds in an older adult is a clinically meaningful risk flag that should trigger comprehensive falls assessment including medication review, vision screening, orthostatic hypotension assessment, and home safety evaluation. Combine with the Timed Up and Go Test for a more complete mobility screen at no additional cost or equipment.
Physical therapists, rehabilitation specialists
Single-leg stance time is a standard balance outcome measure in physical therapy programs targeting fall prevention, vestibular rehabilitation, post-stroke balance recovery, and lower extremity strengthening. It sensitively tracks improvements in ankle proprioception, hip abductor strength, and vestibular function over 6-12 week intervention periods. A clinically meaningful improvement is generally considered to be 3 or more seconds on repeated testing. PT programs demonstrate 5-15 second improvements in single-leg stance time after 8-12 weeks of targeted balance training.
Neurologists, movement disorder specialists, vestibular PTs
Single-leg stance testing is particularly sensitive in Parkinson's disease, where postural instability and impaired ankle proprioception produce dramatically reduced single-leg stance times even in the early stages of the disease. Serial testing tracks disease progression and response to physical therapy or medication changes. In vestibular disorders, comparing stance time with eyes open versus eyes closed (Romberg augmentation) differentiates vestibular from proprioceptive balance impairment — reduced eyes-closed performance indicates vestibular dysfunction.
Orthopaedic surgeons, rehabilitation medicine physicians, PTs
After hip fracture, ankle fracture, or lower extremity surgery, single-leg stance time on the affected limb documents rehabilitation progress and discharge readiness. The goal of achieving 10+ seconds on the affected side is a common rehabilitation milestone before clearance for unsupervised community ambulation. Single-leg stance ability also predicts the risk of contralateral hip fracture — patients who cannot stand on the non-fractured limb for 5 seconds have substantially higher risk of bilateral fracture.
Geriatric primary care teams, nurse practitioners
Annual single-leg stance testing in adults 65 and older provides a trackable longitudinal measure of balance function that supplements subjective fall history and questionnaire-based screening. A decline of 3 or more seconds between annual measurements warrants investigation for new neurological or musculoskeletal pathology, medication review, and exercise referral. Documenting the absolute time and whether it was limited by failure or maximum time reached provides more clinical information than a binary pass/fail result.
Asymmetric single-leg stance times — for example, 15 seconds on the right and 5 seconds on the left — are as clinically significant as a low bilateral time. Asymmetric performance suggests a unilateral neurological deficit, prior lower extremity injury, or focal musculoskeletal problem on the weaker side. Always test both legs and document both results. In patients with Parkinson's disease, progressive asymmetry in single-leg stance correlates with unilateral disease lateralization.
Single-leg stance time improves across trials due to learning effects and initial anxiety reduction. The first trial is often significantly shorter than the second and third. Always perform 3 trials on each leg and record the best value. Using single-trial results underestimates true ability and produces lower apparent baseline values that will show spurious improvement at follow-up simply due to test familiarity. Some clinical protocols use the mean of trials 2 and 3 rather than the best of 3, but the best-of-3 approach is most clinically common.
Testing with eyes open primarily relies on visual, vestibular, and proprioceptive inputs. Testing with eyes closed (eyes-closed single-leg stance) removes visual compensation and reveals the contribution of vestibular and proprioceptive systems to balance. A patient who performs well with eyes open but poorly with eyes closed (Romberg-positive) has a vestibular or proprioceptive deficit that relies on vision for compensation. This information guides physical therapy targeting — vestibular rehabilitation for vestibular deficits versus proprioceptive training and ankle strengthening for proprioceptive deficits.
While normative values vary by age, a single-leg stance time below 5 seconds in any adult over 70 is a clinically actionable finding regardless of the specific age-group norm. This threshold was used by Vellas et al. in studies demonstrating 2-3 fold increased injurious fall risk. Patients at this level should not be reassured or monitored without active intervention — they need immediate fall risk assessment, physical therapy referral, and home safety evaluation.
Single-leg stance time varies significantly with footwear type (barefoot vs. sneakers vs. dress shoes), surface compliance (carpet vs. linoleum vs. foam pad), and room brightness. For serial monitoring to be interpretable, standardize all these factors at each assessment. Document the footwear worn, the surface used, and whether the test was performed with eyes open or closed. Unexpected changes in single-leg stance time at follow-up may reflect test administration differences rather than true clinical change.
Single-leg stance testing in older adults with known balance impairment carries fall risk. Always have an examiner standing immediately adjacent to the patient with hands ready to catch — not touching, but poised to stabilize. A parallel bar, countertop, or chair should be within immediate reaching distance. Never leave a patient unattended during the test. Stop the test immediately if the patient shows signs of pre-syncope (pallor, diaphoresis, dizziness complaints) or if their balance appears acutely compromised during the stance.
Two patients who both achieve 5 seconds have different clinical pictures if one failed due to balance loss and the other was stopped because of pain. Document the reason for test termination: balance loss (foot touched floor, arms reached for support), maximum time reached, pain, or fatigue. A patient stopped by pain rather than balance loss may have better actual balance capability than the score suggests, and pain management may significantly improve their functional balance.
For patients too impaired to attempt single-leg stance, tandem stance (one foot directly in front of the other, heel-to-toe) provides a bridge test of increasing balance difficulty. The progression: parallel stance → semi-tandem (feet offset at 45 degrees) → full tandem → single-leg stance represents a difficulty continuum. Using the level at which the patient first fails provides more nuanced balance profiling than single-leg stance alone and guides physical therapy programming at the appropriate level of difficulty.
Single-leg stance duration has longstanding use and associations with balance impairment and falls in older adults.
Lower stance times indicate poorer static balance control and higher fall-risk signal.
Use in outpatient geriatrics, rehab, and fall-risk screening where quick static-balance assessment is needed.
Performance is influenced by footwear, instructions, pain, and neurologic/musculoskeletal comorbidity.
Disclaimer: This tool is for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider with questions about your health.
April 21, 2026 · trust-baseline
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