Four Square Step Test (FSST): free online stopwatch and protocol

Protocol

Dynamic balance and stepping in all directions.

1. Place four canes on the floor in a cross, forming four squares numbered 1 to 4 clockwise. The patient stands in square 1, facing square 2.
2. Instruction: step as fast as possible into each square in turn — forward, right, back, left (1→2→3→4) — then back the other way (4→3→2→1), both feet in each square, facing forward all the time.
3. Demonstrate, allow one practice, then start the stopwatch when the first foot touches square 2.
4. Stop it when the last foot is back in square 1. Repeat if the patient loses balance or touches a cane; keep the best of two trials.

Norms and references

> 15 s: multiple fallers among older adults (Dite & Temple, 2002). Other cut-offs: > 9.7 s in Parkinson's disease, > 15 s after stroke.

Why Rehab Timer?

• One-tap stopwatch, screen kept on during the test
• Speeds and clinical thresholds computed for you
• History, evolution charts and PDF report per patient
• A free stopwatch with laps for any other test

Other tests

• Timed Up and Go (TUG)Functional mobility and fall risk
• 6-Minute Walk Test (6MWT)Distance walked in 6 minutes
• 10-Metre Walk Test (10MWT)Gait speed
• 30-Second Chair Stand (30CST)Number of chair stands in 30 seconds
• Five Times Sit to Stand (5×STS)Lower-limb strength and fall risk
• Single-Leg StanceStatic balance on one leg
• 4-Stage Balance Test (CDC STEADI)Static balance in four stances of increasing difficulty
• 2-Minute Walk Test (2MWT)Distance walked in 2 minutes
• 2-Minute Step Test (2MST)Aerobic endurance: knee raises in place in 2 minutes
• Free stopwatchTime any other test and give it your own name