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Four Step Square Test

Overview and Statistics


Purpose: Assesses dynamic balance and coordination through stepping forwards, sideways, and backwards in a timed fashion

Diagnoses Assessed:

  • Strokes
  • Parkinson's Disease
  • Vestibular disorders
  • Geriatrics

Disease-Specific Statistical Breakdown:


  • Cut-off score: >15 seconds or failed attempt=increased risk of falls for acute stroke patients

Parkinson's Disease:

  • Cut-off score: <9.68 seconds=higher risk of falls
  • Test rest reliability:
    • On medication=.78
    • Off medication=.90
  • Inter-rater reliability=.99

Vestibular Disorders:

  • Cut-off score: >12 seconds=increased risk of falls
  • Test-retest reliability=.93


  • Cut-off score: >15 seconds=greater risk of falls
  • Test-retest reliability=.98
  • Inter-rater reliability=.99



1. Rehab measures: Four Step Square Test. Rehabilitation Measures Database Web site. 2013. Available at: Accessed March 25, 2014.