Examination Technique:

1. General

  • ask the patient to stand with feet together and once they feel comfortable, close their eyes.

  • if they cannot balance well with eyes open, do not have them close their eyes.

  • stand close to the patient and be ready to support them should they fall to either side.

2. Postural stability (retropulsion or forced pull back test)

  • with eyes open, ask the patient to stand with feet comfortably apart, stand behind close to the patient and explain that you will deliver a quick pull back.

  • ask the patient to maintain their stability and try not to move backwards.

  • be prepared to catch the patient under the arms should they fall backwards.

Abnormal Response:

  • patients with extrapyramidal disorders (e.g. Parkinson’s disease) often show retropulsion and may take several steps backwards and be unable to maintain their stability.