Execution
- 1Position the patient standing near a support and guards closely.
- 2Ask the patient to stand on one leg with eyes open first.
- 3Ask the patient to close the eyes while maintaining single-leg stance if safe.
- 4Time the hold and record foot touchdown, trunk strategy, stepping, or use of support.
- 5Repeat on the other leg and compare sides and eyes-open versus eyes-closed performance.
Positive outcome
Early loss of balance or marked asymmetry with eyes closed suggests impaired balance integration, with increased vestibular reliance when vision is removed. The test is not specific because ankle instability, hip weakness, neuropathy, age, and fear can also reduce performance. A fall risk result should lead to safer balance testing and management.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Springer et al. (2007) | normative balance study | NA | NA | NA | NA |
CommentSingle-leg stance with eyes closed is a functional balance screen rather than a diagnostic vestibular test. It can reveal visual dependence or balance vulnerability, but it does not distinguish peripheral vestibular loss from musculoskeletal or sensory causes. Guarding and safety are essential.
Low Clinical Value