Balance and Proprioception: Single-Leg Balance - Eyes Closed

The Single-Leg Balance Eyes Closed Test measures how long a client can stand on one leg without visual input. It is more demanding than the eyes-open version and is closely related to the Unipedal Stance Test, which has published normative values for eyes-open and eyes-closed conditions.  

Introduction

Closing the eyes increases the balance challenge by reducing visual input. This makes the test more sensitive to somatosensory and vestibular contributions to balance.

Quick Summary

Test name: Single-Leg Balance Eyes Closed
Category: Static balance / sensory balance challenge
Primary score: Time held in seconds
Best use: Balance progression and side-to-side comparison
Key limitation: It is much harder than eyes-open testing and may not be appropriate for all clients.

What Is the Assessment?

The client stands on one leg with eyes closed while maintaining balance for as long as possible or until the time cap is reached.

Why It Is Used

Used to assess balance without visual input, proprioceptive control, side-to-side differences and progress over time.

What It Measures

It may reflect vestibular, somatosensory and lower-limb balance control under reduced visual input.

Who It Is Used For

Useful for athletes, active adults and clients who can safely perform more challenging static balance tests. Use caution in older adults or clients with high fall risk.

Equipment Required

• Flat surface
• Stopwatch or Measurz stopwatch
• Safety support nearby
• Optional Measurz AR measurement for setup documentation
• Measurz/MAT platform for time, side and symptoms

Step-by-Step Protocol

1. Client stands upright near support but without touching it.
2. Hands and foot position are standardised.
3. Client lifts one foot.
4. Once stable, client closes eyes.
5. Start timing.
6. Stop when eyes open, foot touches down, stance foot moves, support is used or the time cap is reached.
7. Repeat both sides.

Scoring and Interpretation

Record time in seconds, side, time cap, stance rules, symptoms and reason for stopping.

Normative Data, Benchmarks or Reference Values

Eyes-closed times are normally much shorter than eyes-open times. Published UPST normative values support age- and sex-specific interpretation.  

Practical field guide only:

• 20+ seconds: strong eyes-closed balance for many active adults
• 10–20 seconds: moderate
• Under 10 seconds: developing or worth monitoring
• Use age-specific values where available.

Reliability and Validity

Reliability depends on consistent rules, time cap, surface, number of trials and whether the timing starts before or after the eyes close. Normative values are available for UPST eyes-closed testing.  

Common Errors and Limitations

Common errors include unsafe setup, starting timing before the client is stable, inconsistent time caps, allowing the eyes to open and not recording surface or footwear.

Practical Applications

Useful for balance progression, sensory balance monitoring, athletic balance profiling and side-to-side comparison.

How to Record This in Measurz/MAT

Record side, time, eyes condition, time cap, surface, footwear, symptoms, support use and retest date.

FAQs

Is it harder than eyes open? Yes.
Should support be nearby? Yes, for safety.
Are norms available? Yes, for unipedal stance eyes-open/closed protocols.
Can it diagnose vestibular problems? No, it can indicate balance difficulty but does not diagnose.

Key Takeaways

• Removes visual input.
• More challenging than eyes-open balance.
• Safety setup is essential.
• Use age-appropriate interpretation.
• Measurz can track time and side.

References

Springer, B. A., Marin, R., Cyhan, T., Roberts, H., & Gill, N. W. (2007). Normative values for the Unipedal Stance Test with eyes open and closed. Journal of Geriatric Physical Therapy, 30(1), 8–15.