FICSIT-4
 (Frailty and Injuries: Cooperative Studies of Intervention Techniques) 
Tests of Static Balance: 
parallel, semi-tandem, tandem, and one-legged stance tests

Journals of Gerontology Series A: Biological Sciences and Medical Sciences, Vol 50, Issue 6 M291-M297, Copyright © 1995 by The Gerontological Society of America 
MULTICENTER STUDY 
A cross-sectional validation study of the FICSIT common data base static balance measures. Frailty and Injuries: Cooperative Studies of Intervention Techniques
JE Rossiter-Fornoff, SL Wolf, LI Wolfson and DM Buchner 
Division of Biostatistics, Washington University School of Medicine, St. Louis, USA. 

BACKGROUND. Two simple balance scales comprising three or four familiar tests of static balance were developed, and their validity and reliability are described. The scales were such that the relative difficulties of the basic tests were taken into consideration. METHODS. Using FICSIT data, Fisher's method was used to construct scales combining ability to maintain balance in parallel, semi-tandem, tandem, and one-legged stances. Reliability was inferred from the stability of the measure over 3-4 months. Construct validity was assessed by cross- sectional correlations. RESULTS. Test-retest reliability (over 3-4 months) was good (r = .66). Validity of the FICSIT-3 scale was suggested by its low correlation with age, its moderate to high correlations with physical function measures, and three balance assessment systems. The FICSIT-4 scale discriminated balance over a wide range of health status; the three-test scale had a substantial ceiling effect in community samples. CONCLUSION. A balance scale was developed that appears to have acceptable reliability, validity, and discriminant ability.

Timing is stopped if:
•	the person displaces their stance foot
•	the suspended foot touches the ground
•	the suspended foot touches the other calf for support (cue the person to avoid this)

INSTRUCTIONS: Demonstrate each position to the subject, then ask them to perform and time. 

F-1. FEET CLOSELY TOGETHER, UNSUPPORTED, eyes open (ROMBERG POSITION)
INSTRUCTIONS: Stand still with your feet together as demonstrated for 10 seconds. [Berg #7 = 60 seconds]
4 able to stand 10 seconds safely 
3 able to stand 10 seconds with supervision 
2 able to stand 3 seconds  
1 unable to stand 3 seconds but stays steady  
0 needs help to keep from falling 
If subject is able to do this, proceed to the next position, if not, stop.

F-2. FEET CLOSELY TOGETHER, UNSUPPORTED, eyes closed (ROMBERG POSITION)
INSTRUCTIONS: Please close your eyes and stand still with your feet together as demonstrated for 10 seconds.
4 able to stand 10 seconds safely 
3 able to stand 10 seconds with supervision 
2 able to stand 3 seconds 
1 unable to keep eyes closed 3 seconds but stays steady 
0 needs help to keep from falling 
If subject is able to do this, proceed to the next position, if not, stop.

F-3. SEMI-TANDEM: eyes open HEEL OF 1 FOOT PLACED TO THE SIDE OF THE 1ST TOE OF THE OPPOSITE FOOT (SUBJECT CHOOSES WHICH FOOT GOES FORWARD)
INSTRUCTIONS: Please stand still with your feet together as demonstrated for 10 seconds.
4 able to stand 10 seconds safely 
3 able to stand 10 seconds with supervision 
2 able to stand 3 seconds 
1 unable to stand 3 seconds but stays steady 
0 needs help to keep from falling 
If subject is able to do this, proceed to the next position, if not, stop.

F-4. SEMI-TANDEM: eyes closed HEEL OF 1 FOOT PLACED TO THE SIDE OF THE 1ST TOE OF THE OPPOSITE FOOT (SUBJECT CHOOSES WHICH FOOT GOES FORWARD)
INSTRUCTIONS: Please close your eyes and stand still with your feet together as demonstrated for 10 seconds.
4 able to stand 10 seconds safely 
3 able to stand 10 seconds with supervision 
2 able to stand 3 seconds 
1 unable to keep eyes closed 3 seconds but stays steady 
0 needs help to keep from falling 
If subject is able to do this, proceed to the next position, if not, stop.

F-5. FULL TANDEM: eyes open HEEL OF 1 FOOT DIRECTLY IN FRONT OF THE OTHER FOOT (SUBJECT CHOOSES WHICH FOOT GOES FORWARD) [Berg #14 = 30 seconds]
INSTRUCTIONS: Please stand still with your feet together as demonstrated for 10 seconds.
4 able to stand 10 seconds safely 
3 able to stand 10 seconds with supervision 
2 able to stand 3 seconds 
1 unable to stand 3 seconds but stays steady 
0 needs help to keep from falling 
If subject is able to do this, proceed to the next position, if not, stop.

F-6. FULL TANDEM: eyes closed HEEL OF 1 FOOT DIRECTLY IN FRONT OF THE OTHER FOOT (SUBJECT CHOOSES WHICH FOOT GOES FORWARD)
INSTRUCTIONS: Please stand still with your feet together as demonstrated for 10 seconds.
4 able to stand 10 seconds safely 
3 able to stand 10 seconds with supervision 
2 able to stand 3 seconds 
1 unable to stand 3 seconds but stays steady 
0 needs help to keep from falling 
If subject is able to do this, proceed to the next position, if not, stop

F-7. STANDING ON ONE LEG: eyes open   [Same as Berg #13]
INSTRUCTIONS: Stand on one leg as long as you can without holding.
4 able to lift leg independently and hold >10 seconds 
3 able to lift leg independently and hold 5-10 seconds 
2 able to lift leg independently and hold = or >3 seconds 
1 tries to lift leg unable to hold 3 seconds but remains standing independently 
0 unable to try or needs assist to prevent fall

Total FICSIT-4 Static Balance score = ____ / 28