Key numbers
24%
Lower rate of falls with balance and functional exercise (Cochrane review)
7920 participants
Participants behind that figure
What Systematic recommends
Where to start
- Stand next to the wall or stable surface with bare feet flat on the ground. Reach to the wall with two fingertips, using only very light contact.
- Keep your eyes focused straight ahead on your chosen visual point. Maintain awareness of the tripod points of contact through the standing foot. Keep the standing knee soft and active.
- Begin with a 10-second hold. 3 sets. Work toward a 30-second hold. Progress in 10-second increments. Use as little fingertip contact with the wall as you can comfortably control.
Condensed from the published Development Pathway (Single-Leg Balance: Two Finger Wall-Assist Tripod Stand). This is a starting point, not a training program or medical advice.
What balance is
The Single-Leg Balance test measures postural control on one leg: keeping your body organized over a reduced base of support. It depends on two things working together, the senses that tell you where you are and the muscles that respond.
Your nervous system keeps you upright by continuously combining information from your eyes, your inner ear (the vestibular system) and the sensors in your skin, muscles and joints, and by shifting how much it relies on each.
Why closing your eyes makes it harder
Vision is one of the main sources of that information. Close your eyes and your nervous system has to lean harder on your inner ear and on the sensors in your feet and legs, and reorganize how it keeps you steady. That is what the eyes-closed test exposes.
The test challenges that whole system, not one joint or one sense organ.
How balance changes with age
Eyes-closed single-leg stance declines strongly with age; Springer and colleagues published age-related reference data for it. Tedeschi and colleagues (2024) studied 120 healthy adults aged 30 to 65, which covers the middle of life.
Araújo and colleagues (2022) linked being able to hold a one-leg stance for 10 seconds to survival. That is a different test from the Systematic one, which is timed with your eyes closed, so the two results should not be compared.
What the research shows about falls
In older adults, poorer balance is associated with a higher risk of falling. One large review could not give a single summary figure for balance, because the studies measured it in ways that could not be compared. Falls themselves reduce independence and quality of life, and are associated with more illness, death and health costs.
The encouraging part is about exercise. A Cochrane review found that balance and functional exercises cut the rate of falls by 24% compared with control (rate ratio 0.76, 95% CI 0.70 to 0.81), based on 7920 participants from 39 studies, with high-certainty evidence. They also reduced the number of people who fell at least once by 13%.
Programs mixing several types of exercise, most often balance and functional work plus resistance training, probably reduce the rate of falls by 34%, though that estimate rests on fewer studies and moderate-certainty evidence.
How the Systematic test is done
The test is timed with no upper limit. It ends if your standing foot hops, shifts or repositions. Where your free foot goes matters to the result, so Systematic specifies it: that placement is Systematic's own protocol choice, not copied from the research.
In this capacity
- Does balance training improve balance in older adults?
- Why is balancing with your eyes closed so much harder?
- Does exercise prevent falls in older adults?
- Does foot position change single-leg balance?
- How long can people balance on one leg at different ages?
- Does standing on one leg for 10 seconds predict survival?
- Why does balance decline with age?
- Why do older adults fall?
The evidence
Each cited source is labeled according to how it supports the particular claim on this page. Direct test evidence, underlying-capacity findings and population reference values are distinguished from Systematic-defined protocols and standards. Historical development notes are retained internally rather than presented as public evidence. A study of an underlying capacity is never presented as validation of the Systematic test itself.
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Underlying-capacity evidence New source
Sherrington et al. (2019). Exercise for preventing falls in older people living in the community. The Cochrane database of systematic reviews.
What it found. Balance and functional exercises reduce the rate of falls and the number of people experiencing falls, based on thousands of participants with high-certainty evidence.
What it does not show. Does not show that a single balance test by itself prevents falls.
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Underlying-capacity evidence New source
Howe et al. (2011). Exercise for improving balance in older people. The Cochrane database of systematic reviews.
What it found. In older adults, diminished balance is associated with an increased risk of falling.
What it does not show. Does not provide a single comparable cutoff for single-leg balance time by age.
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Underlying-capacity evidence New source
Deandrea et al. (2010). Risk factors for falls in community-dwelling older people: a systematic review and meta-analysis. Epidemiology (Cambridge, Mass.).
What it found. For balance as a fall risk factor, authors did not compute a summary estimate because measures were not comparable.
What it does not show. Does not define a single threshold for impaired balance.
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Underlying-capacity evidence New source
Montero-Odasso et al. (2022). World guidelines for falls prevention and management for older adults: a global initiative. Age and ageing.
What it found. Falls in older adults have negative effects on functional independence and quality of life and are associated with increased morbidity, mortality and health-related costs.
What it does not show. Does not show that fall history causes mortality, only an association.
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Normative/reference evidence
Springer et al. (2007). Normative Values for the Unipedal Stance Test with Eyes Open and Closed. Journal of Geriatric Physical Therapy.
What it found. There is a strong age-related decline in eyes-closed unipedal stance and the study provides valuable age-related eyes-closed reference data.
What it does not show. Does not use the Systematic single-trial uncapped exact protocol.
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Normative/reference evidence
Tedeschi et al. (2024). Assessment of Balance During a Single-Limb Stance Task in Healthy Adults: A Cross-Sectional Study. Perceptual and Motor Skills.
What it found. Studied 120 healthy adults ages 30 to 65 for single-limb stance.
What it does not show. Does not show fall outcomes or long-term survival.
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Underlying-capacity evidence
Peterka (2002). Sensorimotor Integration in Human Postural Control. Journal of Neurophysiology.
What it found. Balance is maintained by continuously integrating visual, vestibular and somatosensory information and postural control emerges from reweighting that information; removing vision requires greater reliance on remaining senses.
What it does not show. Does not give specific single-leg balance times by age.
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Underlying-capacity evidence
Schneiders et al. (2016). Effect of foot position on balance ability in single-leg stance with and without visual feedback. Journal of Biomechanics.
What it found. Eyes-closed single-leg performance is sensitive to free-foot position and supports standardizing foot placement.
What it does not show. Does not prescribe the Systematic initiate a step, foot 1 to 12 inches clear choice.
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Underlying-capacity evidence
Araujo et al. (2022). Successful 10-second one-legged stance performance predicts survival in middle-aged and older individuals. British Journal of Sports Medicine.
What it found. Studied a 10-second one-leg stance and survival in middle-aged and older adults.
What it does not show. It used a 10-second stance, not the Systematic eyes-closed timed test, and does not report eyes-closed times.
The Systematic Healthspan Assessment is a physical baseline. It is not a diagnosis, and it does not estimate a biological age, a disease risk or a lifespan.