Part of Strength and balance exercises for seniors: where to start
Balance tests for seniors: what a result means and what to do next
Warning signs, and when to get help
What a balance test for seniors can and cannot tell you
A balance test is a measurement, no different in that respect from a blood pressure reading. It is good for noticing that something has changed since last year, for showing which part of a movement has become hard, and for giving a physio a starting point to measure against after a few weeks of work. What it cannot do is tell you whether you are going to fall, and anyone who offers you that from one number is overselling it.
NICE put this in writing for clinicians in its falls guideline, which covers older people and people aged 50 and over at higher risk. The recommendation is not to use falls risk prediction tools to predict a person's risk of falling (NICE NG249). If a scoring tool built for the job is not reliable enough for that, a hold time counted at your kitchen counter certainly is not.
So the question is not "what is my number" but "has this changed, and what is making it worse". A balance problem usually has causes behind it, and those causes are what a doctor or physio can do something about.
A sudden loss of balance is different. Call emergency services straight away for any sign of a stroke, even if it goes away: sudden dizziness with unsteadiness or falling over, a face that droops on one side, an arm you cannot lift or keep up, slurred or muddled speech, weakness or numbness on one side of your body or face, sudden blurred vision, double vision or loss of sight, trouble swallowing, a sudden severe headache, or a sudden fall where your legs give way but you do not black out (a drop attack).
How can you check your balance at home safely?
Set the room up before you do anything else, because the setup is the whole difference between a check and a fall. Stand within arm's reach of a kitchen counter or a sturdy chair that cannot slide, on a firm floor with rugs, mats and cables moved out of the way. Keep a hand on the support. Wear flat shoes that fit well and grip the floor, not socks, tights or bare feet. Keep your phone in your pocket rather than in another room, and pick a time when someone else is at home.
If you have fallen in the past year, feel unsteady on your feet, or take medicines that make you dizzy, keep a hand on the support throughout, practice only when someone else is at home, and ask your doctor or physio about a falls check.
One group should not start any of this from a page. If you have had a hip or knee replacement, surgery for a broken hip, or any other operation on your leg or your spine in the past few months, ask your surgeon or physio which standing checks you may do before you do any of them. Teams differ on this, and some will tell you to keep away from deep bending, and from crossing or twisting the operated leg, for the first weeks, which rules out narrowing your feet and turning on the spot. Your own team's instructions come first, because they know which operation you had and how it was done.
If you live alone, that rule still stands, so plan around it rather than ignoring it. Do the exercises that ask for someone to be at home at your physio appointments or in a class instead, keep to the seated and supported work when you are on your own, and ask your physio which of the standing exercises you may do alone. Keep your phone in a pocket rather than in another room, so you can reach it from the floor, and ask about an alarm you wear.
If you do fall and cannot get up, or you think you may have hurt your head, neck, back or hip, stay where you are, keep warm and call emergency services, or get someone to call for you. Do not let anyone haul you up first. That line and the rest of the fall routes, including what to do if you got up fine and only hurt later, are in the warning signs below. Rehearsing the way back onto your feet is a separate job, and our page on getting up from the floor covers it.
Stop at once if this happens while you are checking anything. You feel dizzy, lightheaded, faint or sick, or the room seems to spin. Hold your support, sit down and get medical advice the same day before you practice again. If you faint, it does not settle within a few minutes of sitting still, your vision suddenly blurs or goes double, or you cannot stand or walk steadily, call emergency services.
What should you actually be noticing, if there is no stopwatch involved? What tells you most is your own week, not a test. Whether you now use the hand on the counter for jobs you used to do without it. Whether turning around in a small kitchen takes three shuffles instead of one movement. Whether you reach for the wall on the stairs, carry one thing at a time now, or have started planning a route round the furniture.
Those changes are what a physio wants to hear about. They beat a hold time, because they are the thing itself and not a stand-in for it.
How long should you be able to stand on one leg?
The honest answer is that we are not going to give you a time, and you should be suspicious of any page that does. The figures that go round in news stories were not produced to tell an individual older adult whether they are at risk of falling, and NICE guidance says plainly that an individual's falls risk should not be predicted from a risk tool at all (NICE NG249). Nothing we have read supports handing an individual older adult a hold time as a falls cut-off.
There is a safety reason on top of the evidence one. A target turns a check into a challenge. Someone who has been told to manage a certain number of seconds will take the hand off the counter to get there, and standing unsupported on one leg, alone, to beat a clock is a worse idea than never knowing the number.
If you want to train the positions instead of measuring them, each one has its own page with its own support instructions, starting point and stop signs: semi-tandem stance, tandem stance and single leg stance. Read those instead of copying a hold time from here, and if you have fallen in the past year or feel unsteady, your hand stays on the support while the feet get narrower. Taking your hand off is a change to make with your physio, not on your own at home. If you are in the first months after hip or knee surgery, the narrower foot positions wait for your surgical team, for the reason given above.
The tests a physio or doctor uses, and what each one is for
Three short tests turn up again and again, and none of them is a verdict on its own. Each one has its own page on this site with the full procedure, the published figures and the limits of those figures, written for the clinician running it. If a test has been done on you, that is where to read about your result.
The Timed Up and Go folds standing up, walking a short distance, turning and sitting back down into one timed run, so a slow time points at the whole sequence and not at one joint. Our Timed Up and Go test page carries the published times by age, the falls-risk cut-offs and the research on how well they actually predict a fall, which is the part most summaries leave out. The World Falls Guidelines recommend measuring walking speed to assess falls risk and give the Timed Up and Go as an alternative, while noting that the evidence for predicting falls from it is less consistent (Montero-Odasso 2022). You can also practice the sequence as an exercise, as timed up and go practice, rather than as a test.
The 30-second chair stand counts how many times you can stand up fully from a chair with your arms crossed, so it measures leg strength more than balance. It earns its place because the same chair is always to hand, so it is easy to repeat after a few weeks of training. The norms and the screening table are on the 30-second chair stand test page. Crossing your arms also takes away the hands you would normally push up with, so this is a test to have run on you rather than one to try alone against a clock.
Some people need it cleared by a doctor or their treating team before anyone runs it at all. That includes anyone who has had recent hip or knee surgery, unless the surgeon's protocol allows repeated standing from a 17 inch (43 cm) chair, anyone who gets chest pain, angina or dizziness on exertion, anyone with a resting blood pressure over 160/100 or heart failure that is not stable, anyone a doctor has told not to exercise, and anyone who is unwell or whose joint pain is clearly worse for standing up from a chair. The 30-second chair stand test page carries that same list and the signs that stop the test part way through.
If you have had a hip replacement, get the go-ahead from your surgeon or physio before you try sit to stand without using your hands. Two things sit behind that. Standing up from a low seat bends the hip further than a right angle, which is the position several teams ask you to keep away from in the first weeks after a replacement done from behind the hip, and going without your hands puts your whole weight through one leg at a time while the muscle and capsule cut to reach the joint are still healing. Surgeons genuinely differ here, and some set no movement restrictions at all after the same operation, so the chair height, the timing and whether you may fold your arms are your own surgical team's call and not this page's. The same goes after surgery for a broken hip or a knee replacement.
The movement itself is the sit to stand exercise, and once your team has cleared it, that is usually where a leg strength program starts.
The six-minute walk test is a different animal again. It measures how far you can walk on the flat in six minutes, so it is about stamina and how your heart, lungs and legs cope together, and it belongs to heart and lung rehabilitation more than to falls work. It also comes with its own list of reasons not to run it at all, which is part of why it is not a self-test.
Why one cut-off does not decide your falls risk
Falls do not have one cause, which is why one measurement cannot settle them. When the NHS describes what a specialist falls service does, it lists checking for muscle weakness, weak bones (osteoporosis) and eyesight problems, strength and balance training, checking that your home is safe, and reviewing your medicines (NHS). That is several different kinds of problem in one appointment, and a timed walk across a clinic room can only ever see one of them.
The other half of it is that a reassuring result can be wrong. The research on how well a single mobility test predicts who falls is set out on our Timed Up and Go test page, and it is not flattering: a quick time does not clear you, and a slow one is a reason to look further, not a diagnosis. Treat any result as one line in a longer conversation.
Some unsteadiness also has a cause of its own, with its own program behind it. Dizziness, spinning or a problem that comes on when you move your head belongs with dizziness and BPPV. Numb or burning feet belong with peripheral neuropathy. Balance changes with Parkinson's disease need a program set for that condition. In all three cases, a score from a general balance test tells you much less than the diagnosis does.
What to do if your balance is worse than you expected
Start by not panicking about it, because this is a risk factor that responds to work. The Cochrane review of exercise for older people living at home found that exercise lowered the rate of falls by 23% compared with control, from 59 studies and 12,981 people, and the reviewers rated that high-certainty evidence (Sherrington 2019). Balance is a skill, and skills improve with practice that is hard enough to count.
Our balance and falls prevention program is the place to go next. It sets out the three stages, how much support to keep, how often to practice and how to progress, and it starts with everything done beside a counter. If standing up from chairs and getting off the floor are the harder part, strength for older adults covers the leg strength side of the same problem. The balance exercise library has the individual exercises with videos, including gentler ones like the standing forward reach, and the rest of this topic is gathered on the strong and steady hub.
The NHS asks for balance exercises at least twice a week alongside its sitting, flexibility and strength routines (NHS). Your physio will adjust this to what you can manage, and a first appointment is worth it even if you then do the work at home, because the starting stage and the amount of support are the two things worth getting right.
What a falls assessment includes, and how to ask for one
A falls assessment is not a test you pass or fail. It is an appointment that goes looking for the causes, which is why it covers your legs, your bones, your eyes, your home and your medicine list instead of one score.
The NHS advises seeing a GP if you have had a fall or you are worried about your balance or mobility, and says the GP may refer you to a specialist falls service. In some areas you can refer yourself to that service without seeing a GP first (NHS). Ask the reception at your own surgery which applies where you live.
NICE sets out who should be offered a comprehensive falls assessment, and the triggers are about your history rather than your test result. If you have fallen in the last year, any one of these is enough on its own: you were injured in the fall and needed medical treatment, you have had two or more falls in the last year, you are living with frailty, you lost consciousness in connection with a fall, or you could not get up afterwards without help (NICE NG249). Our balance and falls prevention page covers the assessment and what the appointment looks at.
Two practical notes from clinic. Write your falls down before you go, including the ones where you were not hurt, because almost everyone under-reports them in the room. And bring your medicines or a current list, since some can leave you unsteady, especially on standing. Changing or stopping one is a conversation with your doctor or pharmacist, never something to do on your own.
If weak bones are part of the picture, the osteoporosis program shows how to bend, lift and load safely, and it matters here because the fall and the bone are two separate problems that each need their own plan.
When unsteadiness needs a doctor rather than a test
Some things on this page are not questions for a measurement at all. Stop at once if you get chest pain or pressure, dizziness or feeling faint, a racing or irregular heartbeat, or being far more out of breath than the effort should cause. If chest pain, pressure or tightness does not ease quickly when you rest, spreads to your arm, neck, jaw, stomach or back, or comes with sweating, feeling sick, feeling light-headed or being short of breath, call emergency services straight away, as this can be a heart attack. If it eases quickly and none of these happen, get medical advice the same day, and do not exercise again until you have been checked.
New dizziness or lightheadedness on standing, a blackout, a fall you cannot account for, or new hip or groin pain after even a small fall all have their own route and their own timing, and they come before any test. Read the warning signs below before you check anything, because each one says how quickly to get help. Check with your doctor before you start if you have a heart or lung condition, or blood pressure that is not under control.
Book a physio or physical therapist appointment if your balance has changed over the past few months, if you have had any fall at all, or if you are not sure which stage of a program is safe for you. One visit is usually enough to set the starting point and the support, and it is a better use of your time than a number you measured alone.
Related exercise programs
- Balance and falls prevention
- Strength training for older adults
- Osteoporosis
- Dizziness and BPPV
- Parkinson's disease
Warning signs
Get emergency help now
- Emergency: call emergency services straight away for any sign of a stroke, even if it goes away: sudden dizziness with unsteadiness or falling over, a face that droops on one side, an arm you cannot lift or keep up, slurred or muddled speech, weakness or numbness on one side of your body or face, sudden blurred vision, double vision or loss of sight, trouble swallowing, a sudden severe headache, or a sudden fall where your legs give way but you do not black out (a drop attack).
- Emergency: you have just fallen and cannot get up, or you think you may have hurt your head, neck, back or hip. Stay where you are, keep warm and call emergency services, or get someone to call for you. If you got up and walked without trouble and only notice pain later, use the same-day lines in this list instead.
- Emergency: you fell and cannot remember the fall or how it happened. Go to an emergency department straight away, and do not drive yourself. You may have blacked out or hit your head without knowing it.
- Emergency: you have had a fall or an injury and now have severe hip pain, or you cannot walk or put weight on the leg. Call emergency services or go to an emergency department. This can be a sign of a broken hip (hip fracture).
- Emergency: you have had a hip replacement and have sudden severe pain in your hip or groin, sometimes with a clunk or pop, and you cannot move the leg or put weight on it, or the leg suddenly looks shorter or turned in or out. Do not try to walk on it or push it back into place. Keep still and call emergency services or go to an emergency department, and do not drive yourself. Your new hip may have come out of its socket (dislocated), and a medical team needs to put it back.
- Emergency: after a knock to the head, being very drowsy or finding it hard to keep your eyes open, confusion, a fit (seizure), new weakness or numbness anywhere in your body, new trouble understanding, speaking, walking or keeping your balance, new problems seeing or hearing, clear fluid coming from your ears or nose, bleeding from your ears or bruising behind them, a black eye when your eye was not hit, a dent in your head or a wound with something stuck in it, or a change in behavior. Call emergency services straight away. These can be signs of an injury to the brain.
- Emergency: after a knock to the head, you were knocked out, even for a moment, you cannot remember what happened just before or after, you have had a headache ever since, or you are being sick (vomiting). The same applies, even if you feel fine, if you take medicine that thins your blood, other than aspirin on its own, have a bleeding or clotting condition, have had brain surgery in the past, or had been drinking alcohol or taking drugs when it happened. Go to an emergency department straight away, and do not drive yourself.
- Emergency: if chest pain, pressure or tightness does not ease quickly when you rest, spreads to your arm, neck, jaw, stomach or back, or comes with sweating, feeling sick, feeling light-headed or being short of breath, call emergency services straight away, as this can be a heart attack. If it eases quickly and none of these happen, get medical advice the same day, and do not exercise again until you have been checked.
Get help today
- Same day: after a fall, you are in pain, have hurt yourself or feel unwell, or you were on the floor for an hour or more, without any of the emergency signs above. Get medical advice the same day, even if you managed to get up.
- Same day: you blacked out or fainted, even for a moment. Get medical advice the same day. Call emergency services instead if the person is not breathing, cannot be woken within 1 minute, has not fully recovered or has trouble speaking or moving, has chest pain or a pounding, fluttering or irregular heartbeat, fainted while exercising or lying down, is shaking or jerking, or was badly hurt.
- Same day: dizziness, lightheadedness, blurred vision or feeling faint when you stand up that is new for you, does not pass within a minute or two, keeps happening, or has made you fall. Sit or lie down, and get medical advice the same day. This can be a drop in blood pressure on standing (postural hypotension), a type of low blood pressure, which the NHS lists among the causes of falls, and your doctor can check it. Tell them about your medicines, because some can cause it. If it does not settle within a few minutes of sitting or lying still, call emergency services. If you faint, use the fainting line above.
- Same day: sudden new dizziness, or feeling faint or unsteady, other than the brief lightheadedness as you stand up covered in the line above, without any of the stroke signs above. Stop, sit down and get medical advice the same day. If you faint, it does not settle within a few minutes of sitting still, or you cannot stand or walk steadily, call emergency services.
- Same day: new hip or groin pain after a fall, even a small one, if you are older, have low bone density (osteoporosis) or have taken steroid tablets for a long time, even if you can still walk. Get medical advice the same day. A broken hip is not always obvious at first.
- Same day: you have had a hip replacement and, after a fall or a knock, even a small one, your hip, groin or thigh is newly painful, bruised or swollen, even if you can still walk and your leg looks normal. Stop the exercises, go back to your crutches or frame and keep your full weight off that leg, and contact your surgical team or get medical advice the same day. A break in the bone around a new hip is not always obvious at first, and walking normally on one can move the broken ends apart.
- Same day: you have had a hip replacement and your hip clunks and feels as if it partly slipped out of place and went back, even if it settles straight away and your leg looks normal. Stop the exercises, avoid the movement that brought it on, go back to your crutches or frame, and keep away from deep bending, crossing your legs and twisting on that leg until you have been seen. Contact your surgical team or get medical advice the same day. If the leg then looks shorter or turned, or you cannot move it or put weight on it, call emergency services.
Book an appointment
- Within a few days: you have had a fall, even if you were not hurt, or you keep tripping, stumbling or feeling that your legs might give way. Book an appointment with your doctor within a few days and ask about a falls assessment. Tell them about every fall, even the ones where you were not hurt.
Common questions
How long should you be able to stand on one leg?
We do not give a figure for this, and we would not use one to judge whether you are likely to fall. NICE tells clinicians not to use falls risk prediction tools to predict a person's risk of falling (NICE NG249), and nothing we have read supports handing an individual a hold time as a falls cut-off. There is also a practical reason. A target time is something a reader will try to beat, and standing unsupported to beat a clock at the kitchen counter is how a quiet check turns into a fall. If your balance has changed, that is worth an appointment, not a stopwatch.
Is the one leg test really a longevity test?
Headlines about standing on one leg come round every year or two, and they are not a reason to try it unsupported at home. Whatever a study of health over many years reports, it does not tell you whether you personally are at risk of falling this month, and that is the question most people are actually asking. Ask your doctor or physio for a falls check instead. If it is the position you want to practice, the single leg stance page gives it with its own support instructions and stop signs.
Can I test my own balance alone?
Do the noticing on your own, by all means, but not the testing. Keeping a hand on a counter while you reach for a cup or turn around in the kitchen tells you plenty, and it costs nothing if your balance is worse than you thought. Anything that narrows your feet or lifts one off the floor is done with a hand on the support and another adult in the house. If you live alone, keep to seated and supported movement when you are by yourself and ask your physio which standing work you may do alone. If you are in the first months after hip or knee surgery, your surgical team sets which positions you may use, so follow them rather than this page.
What score is normal on the chair stand test?
The published norms, the screening table and their limits are all on our 30-second chair stand test page, which is written for the clinician running it. We keep the figures there and not here on purpose, because a number is only meaningful next to how the test was done and which group it was measured in. If you are reading the result of a test somebody ran on you, take the number back to them.
Should I close my eyes during a balance test?
Not at home. Closing your eyes takes away the information you were using to stay upright, which is the point of it in a clinic and the problem with it in a kitchen. A physio may ask you to do it while they stand beside you, on a surface they have chosen, and that is the only setting for it. Keep your eyes on a fixed point ahead of you instead of on the floor.
References
- National Institute for Health and Care Excellence. Falls: assessment and prevention in older people and in people 50 and over at higher risk (NG249). 2025. https://www.nice.org.uk/guidance/ng249
- Montero-Odasso M, van der Velde N, Martin FC, et al. World guidelines for falls prevention and management for older adults: a global initiative. Age and Ageing. 2022;51(9):afac205. doi:10.1093/ageing/afac205
- Sherrington C, Fairhall NJ, Wallbank GK, et al. Exercise for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews. 2019;(1):CD012424. doi:10.1002/14651858.CD012424.pub2
- NHS. Falls. https://www.nhs.uk/conditions/falls/
- NHS. Balance exercises. https://www.nhs.uk/live-well/exercise/strength-and-flexibility-exercises/balance-exercises/
- NHS. Symptoms of a stroke. Page last reviewed 12 September 2024. https://www.nhs.uk/conditions/stroke/symptoms/
- NHS. Head injury and concussion. Page last reviewed 29 May 2025. https://www.nhs.uk/conditions/head-injury-and-concussion/
- NHS. Fainting. Page last reviewed 17 August 2026. https://www.nhs.uk/symptoms/fainting/
- NHS. Low blood pressure (hypotension). Page last reviewed 11 July 2023. https://www.nhs.uk/conditions/low-blood-pressure-hypotension/
- NHS. Chest pain. Page last reviewed 8 August 2023. https://www.nhs.uk/symptoms/chest-pain/
Written and checked by the PocketPhysio editorial team. Last updated 2026-10-18.
This page is general education, not a diagnosis or a personal treatment plan. See a physiotherapist or doctor for advice about your own situation.