Eyes-Closed Balance Test (Single-Leg): Protocol and What the Difference vs. Eyes-Open Means

The eyes-closed single-leg balance test is a direct progression of the standard single-leg balance test. Removing vision from the equation forces the vestibular and proprioceptive systems to work alone, without the "crutch" of seeing the environment. The difference between the eyes-open and eyes-closed times is, by itself, very useful data.

It's an ideal test for detecting how much a person relies on vision to maintain balance, which is especially relevant in athletes and older adults.

What does this test measure?

It measures the ability to maintain single-leg balance without visual input, relying exclusively on the vestibular and proprioceptive systems (joints, muscles, and skin of the supporting limb) to detect and correct imbalance.

Comparing it with the time achieved in the eyes-open single-leg balance test lets you calculate the "cost" of removing vision, an indirect indicator of how much that person depends on sight to stabilize themselves.

Equipment needed

• Nothing essential
• A stopwatch
• A firm, safe surface, with a wall or person nearby to prevent falls

Execution protocol

1. The subject stands barefoot or in regular footwear, hands on hips
2. Ask them to lift one foot off the floor, bending the knee to roughly 90°
3. Once stable on one leg with eyes open, ask them to close their eyes
4. Start the stopwatch the moment they close their eyes
5. Stop the stopwatch when any of these events occurs: the raised foot touches the ground, the hands leave the hips, there's a large movement to recover balance, or the maximum time is reached (usually 30 seconds)
6. Repeat with the other leg
7. Calculate the difference compared to the eyes-open time

Common mistakes

• Asking the subject to close their eyes before they're stable on one leg (this mixes the difficulty of finding the support position with that of maintaining it without vision)
• Not having a prior eyes-open reference time, losing the ability to calculate the difference
• Not standing close enough — loss of balance with eyes closed tends to be more sudden and less predictable than with eyes open

How to interpret the result

Comparison	Interpretation
Eyes-closed time similar to eyes-open time	Good proprioceptive/vestibular integration, low visual dependence
Moderate drop (e.g. from 30 s to 10-15 s)	Normal-to-high visual dependence, common in most of the population
Drastic drop (barely holds for a few seconds)	Very high visual dependence — possible underlying proprioceptive or vestibular deficit

As a general reference, healthy young adults typically hold between 15 and 30 seconds with eyes closed on one leg, though with high individual variability. The most useful approach is to compare with the same person's eyes-open time and with the opposite leg.

Relationship with other tests

• Single-leg balance test — the base eyes-open version, essential for calculating the difference
• Romberg test — same principle (removing vision) but with bilateral support, useful if eyes-closed single-leg balance proves too difficult

Turn a difference of seconds into a progress metric

The difference between eyes-open and eyes-closed time is a subtle figure that's almost never recorded, yet it improves very visibly with proprioceptive training. In Movalytics you can log both times (eyes open and eyes closed) for each leg, and see how that difference shrinks as your client improves postural control without relying on vision.

Frequently asked questions

What's a sensible maximum time to record? 30 seconds is usually a reasonable ceiling: few people, even trained ones, easily exceed that time on one leg with eyes closed. Is it normal for the time to vary a lot between attempts? Yes, especially on the first attempts. That's why it's recommended to do 2-3 attempts and keep the best result or the average, using the same methodology in later assessments. Does it make sense to do this with older adults at risk of falls? With great caution. In people at high risk, it may be better to start directly with the bilateral Romberg test with eyes closed before progressing to the single-leg version.