From the Guidelines
Tandem gait is used to test balance, specifically in the context of a 4-Stage Balance Test, as described in the 2024 update from the American Heart Association and the American Association of Cardiovascular and Pulmonary Rehabilitation 1. This test is part of a broader assessment of balance and stability, which includes four standing positions of increasing difficulty. The tandem stance, where one foot is placed in front of the other with the heel touching the toe, is the third position in this test. The ability to maintain this stance for 10 seconds without moving the feet or needing support is evaluated.
- The 4-Stage Balance Test includes:
- Feet side by side
- Instep of one foot touching the big toe of the other foot
- Tandem stance
- Stand on one foot The use of tandem gait in this context highlights its importance in assessing balance and stability, which are critical components of overall physical function and mobility, as emphasized in the update from the American Heart Association and the American Association of Cardiovascular and Pulmonary Rehabilitation 1.
From the Research
Tandem Gait Testing
Tandem gait is used to test various neurological conditions, including:
- Cerebellar disease
- Vestibular and peripheral neuropathies
- Parkinsonism
- Other neurodegenerative conditions 2 It is also used to assess dysfunction in neurologic conditions whose pathologies extend beyond the vermis or vestibulocerebellar module to include interconnected networks throughout the nervous system 2
Clinical Implications
The tandem gait test has been used in various clinical settings, including:
- Concussion evaluation 3
- Vestibular rehabilitation 4, 5
- Assessment of central vestibular dysfunction 6 The test has been shown to be informative in a wide variety of disorders, and its results can be used to guide clinical decisions and develop personalized treatment plans 2, 6, 4, 3, 5
Key Findings
Some key findings related to tandem gait testing include:
- The test can be a useful marker of dysfunction in neurologic conditions 2
- Current recommendations for the tandem gait test may lead to a high false-positive rate in healthy, physically active adults 3
- Sex, concussion history, number of trials, and foot length have little to no influence on scores on the test 3
- Turning times are more variable than times on the straight portions of the test 3