Balance and Proprioception: Double Leg (DL) Balance - Eyes Closed Test

The Double-Leg Balance Eyes Closed Test measures how well a client can maintain quiet standing with both feet on the ground while visual input is removed. It is useful as a simple static balance screen, a low-level progression before tandem or single-leg testing, and a way to monitor confidence and symptom response.

Introduction

Double-leg eyes-closed balance is one of the simplest ways to increase balance challenge without requiring single-leg stance. It is especially useful when a client is not ready for tandem or single-leg testing, or when you want to observe sway, confidence and sensory dependence in a low-risk position.

This test overlaps with the double-leg stance condition used in the Balance Error Scoring System, where athletes stand barefoot, eyes closed, hands on hips for 20 seconds as part of a broader balance error battery. The full BESS includes double-leg, single-leg and tandem stances on firm and foam surfaces.  

Quick Summary

Test type: Static standing balance test
Position: Double-leg stance, eyes closed
Main score: Time held or number of balance errors
Best use: Entry-level balance assessment, sensory challenge and progress monitoring
Main limitation: Often too easy for healthy athletic clients on firm ground
Diagnostic status: Not a stand-alone diagnostic test.

What Is the Double-Leg Balance Eyes Closed Test?

The Double-Leg Balance Eyes Closed Test is a static balance assessment performed with both feet on the ground while the client closes their eyes. Removing vision increases reliance on somatosensory and vestibular inputs, but the test should not be described as isolating either system.

It can be scored as time held, number of errors, or pass/fail against a chosen maximum time. In Measurz, timing plus notes on sway, symptoms and compensations is usually the most practical approach.

Why It Is Used

This test is used to:

• Assess basic static balance with visual input removed.
• Provide a safer starting point before tandem or single-leg testing.
• Monitor balance confidence and symptom response.
• Observe sway, stepping, arm movement and postural strategy.
• Support balance progressions after injury or illness.
• Add a simple sensory challenge to a broader assessment.

It is often most useful as part of a progression: double-leg eyes open, double-leg eyes closed, tandem eyes open, tandem eyes closed, single-leg eyes open and single-leg eyes closed.

What It Measures

The test measures static standing control under an eyes-closed condition. It may reflect:

• Quiet standing balance.
• Confidence without visual fixation.
• Sway control.
• Ability to maintain stance without stepping.
• Symptom response to vision removal.
• Basic readiness for more challenging balance tasks.

It does not diagnose vestibular dysfunction, neurological disease, concussion or falls risk on its own.

Who It Is Useful For

This test may be useful for older adults, general health and fitness clients, post-injury clients, people returning to activity, clients with low balance confidence, and professionals needing a simple first-level balance measure.

Use caution if the client has dizziness, vertigo, recent head injury, high falls risk, acute pain, neurological symptoms or cannot safely stand unsupported.

Equipment Required

• Flat, non-slip surface.
• Stopwatch or Measurz timer.
• Stable support nearby.
• Professional guarding where needed.
• Optional MAT for consistent foot position.

Step-by-Step Protocol / Practice

1. Confirm the client can stand safely with eyes open.
2. Position the client on a flat, firm surface.
3. Standardise foot position. A BESS-style setup uses feet together, barefoot, hands on hips and eyes closed for 20 seconds; if using a wider stance, record the exact stance width.  
4. Ask the client to stand tall and remain as still as possible.
5. Stand close enough to guard without touching.
6. Start timing once the eyes are closed.
7. Stop timing if the client opens the eyes, steps, grabs support, moves the feet, reports symptoms, loses balance or reaches the chosen maximum time.
8. Record one to three trials depending on the purpose.
9. Use the same surface, stance width, footwear, arm position, maximum time and instructions at retest.

Scoring and Interpretation

Record time in seconds, error count, or both.

Common error criteria, based on BESS-style scoring, include opening the eyes, lifting hands from hips, stepping, stumbling, lifting the forefoot or heel, moving out of position, or remaining out of position for too long.  

A longer time or fewer errors may suggest better static balance under this specific condition. More sway, stepping or symptom provocation may suggest the client needs further assessment or a lower-level balance progression.

Normative Data, Benchmarks or Reference Values

Evidence level: Level 2 — closest available benchmarks.

Exact universal norms for a standalone Measurz double-leg eyes-closed timed test are limited. The closest standardised reference is the BESS double-leg stance condition: 20 seconds, barefoot, hands on hips, eyes closed, firm and foam surfaces, scored by errors.  

Use practical comparison guidance:

• Firm surface with feet together should be achievable for many healthy adults.
• Foam surface, narrow stance or symptoms may increase difficulty.
• Compare the client to their own baseline rather than using a universal pass/fail score.
• Record stance width and surface so future comparisons are meaningful.
• Progress to tandem or single-leg testing if the client easily completes the task.

Reliability and Validity

Evidence for the exact standalone double-leg eyes-closed timed test is limited. Reliability evidence is stronger for standardised balance batteries such as the BESS, although BESS reliability varies by population, rater training and scoring conditions. BESS is an observer-rated test with six 20-second conditions, including double-leg stance, single-leg stance and tandem stance with eyes closed.  

Small changes in time or error count should be interpreted cautiously unless the protocol is repeated consistently and the change aligns with symptoms, confidence, function or other balance measures.

Sensitivity and Specificity

Sensitivity and specificity are not usually applicable to this standalone Measurz test because it measures static balance performance rather than diagnosing a condition.

If used within a concussion, vestibular or falls-risk battery, diagnostic interpretation depends on the full validated battery, population and cut-off used. Do not use double-leg eyes-closed balance alone to confirm or rule out a condition.

Common Errors and Limitations

Common errors include using inconsistent foot width, testing without guarding, changing footwear, not recording the surface, allowing the client to open the eyes briefly, and over-interpreting a normal result.

The main limitation is ceiling effect. Many healthy clients may complete the task easily on firm ground, so tandem, single-leg, foam or head-movement progressions may be needed.

Practical Applications

Use this test as an entry-level balance screen, a safety check before harder balance tasks, a post-injury confidence measure, a simple older-adult balance progression, or a symptom-monitoring task where eyes-closed standing is relevant.

How to Record This in Measurz

Record the test name, trial number, score in seconds, error count if used, foot position, stance width, footwear, surface, arm position, maximum time, pain score, dizziness/nausea/headache response, sway, stepping, support use, stopping reason, confidence, comparison to baseline and retest date.

Related Tests / Internal Links

Double-Leg Balance Eyes Open, Tandem Balance Test, Tandem Balance Eyes Closed, Single-Leg Balance Eyes Open, Single-Leg Balance Eyes Closed, Single-Leg Balance with Head Rotation, Single-Leg Balance with Head Up/Down, Functional Reach Test, Measurz app, The MAT.

FAQs

Is this the same as the BESS double-leg stance?

It can be similar if you use the BESS-style setup: barefoot, feet together, hands on hips, eyes closed and 20 seconds. The full BESS is a broader six-condition error-scoring battery.  

Is double-leg eyes closed balance useful for athletes?

It may be too easy on firm ground for many athletes. Use it as a baseline or safety progression, then progress to tandem, single-leg, foam or dynamic balance tasks.

What should stop the test?

Stop if the client opens the eyes, steps, grabs support, moves out of position, reports symptoms or safety becomes a concern.

Can this test diagnose vestibular problems?

No. It may identify that further assessment is useful, but it does not diagnose vestibular dysfunction on its own.

Key Takeaways

Double-leg eyes-closed balance is a simple, low-level static balance challenge. It is most useful when the protocol is consistent and results are interpreted with symptoms, confidence and related balance tests.

References

Bell, D. R., Guskiewicz, K. M., Clark, M. A., & Padua, D. A. (2011). Systematic review of the Balance Error Scoring System. Sports Health, 3(3), 287–295. https://doi.org/10.1177/1941738111403122 

Shirley Ryan AbilityLab. (n.d.). Balance Error Scoring System. Rehabilitation Measures Database.