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Four Square Step Test

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Other Names

  • FSST
  • Four Square Step Test


Demonstration of the four square step test
  • Assess dynamic stability
  • Assess the ability of the subject to step over low objects forward, sideways, and backward
  • Very useful in patients with parkinsons disease, geriatric patients, vestibular disorders, etc


  • Equipment required
    • Stopwatch
    • 4 canes/rods approximately 100 CM
    • Time to administer: 5 minutes
  • Setup
    • The 4 canes are setup in a cross configuration
  • Test
    • Subject is asked to sequentially step over four canes in a cross configuration on the ground
    • The patient starts in square 1, facing square 2
    • Objective: step as fast as possible from one square into the next
    • Sequence: Square 2, 3, 4, 1, 4, 3, 2, 1 (clockwise to counterclockwise)
    • Test procedure may be demonstrated, one practice trial is allowed prior to administering the test.
    • Two trials are then performed, and the better time (in seconds) is taken as the score.
    • Timing starts when the first foot contacts the floor in Square 2 and finishes when the last foot comes back to touch the floor in Square 1.
    • Instructions: “Try to complete the sequence as fast and as safely as possible without touching the sticks. Both feet must make contact with the floor in each square. If possible, face forward during the entire sequence.”
  • Positive test
    • Fails to complete the sequence successfully
    • Loses balance
    • Makes contact with the cane


  • Parkins disease
  • Geriatric Patients
  • Vestibular Disorders


  • Unknown

See Also


Created by:
John Kiel on 25 July 2019 13:29:03
Last edited:
6 April 2023 23:01:09