Stance
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.