The Fukuda Test for Vestibular Function

The Fukuda Step Test is used by physical therapists to help assess dizziness. It is a balance and vestibular test that may be performed during a vestibular and balance exam.

Your vestibular system is the sensory system that helps you maintain balance. The test is used to determine if there is vestibular system weakness on one side of your body.

This article discusses the Fukuda Step Test, what it is used for, and how reliable it may be.

Woman feeling dizzy in waiting room
Hitoshi Nishimura / Taxi Japan / Getty Images 

Purpose of the Fukuda Step Test

The Fukuda Step Test is one of the tests that may be performed during a vestibular and balance exam. A physical therapist may do these tests if you are feeling dizzy, have vertigo, or are having problems maintaining your balance. You can also do the test at home.

When your physical therapist is assessing your balance and vestibular system, he or she will likely perform several tests to determine the cause of your disequilibrium. Other tests that check your eye motion, head and neck motion, and balance may also be performed. Special tests, like the Dix-Hallpike maneuver, may be performed to rule in or rule out benign paroxysmal positional vertigo (BPPV).

How the Fukuda Step Test is Performed

To perform the Fukuda Stepping Test yourself, first make sure you have plenty of space around you. It is also a good idea to have a friend or family member nearby to assist you in performing the test.

  • To start the test, stand in the middle of a room. Place a small piece of tape on the floor in front of your toes to mark your starting position.
  • Close both eyes and hold your arms outstretched directly in front of you. Now, start stepping in place. Your pace should be comfortable as if you were taking a brisk walk. Make sure someone is watching you so you do not bump into anything in the room.
  • Remain walking in place for 50 to 100 steps. After stepping, open your eyes and determine how much your body rotated to one side or the other.

How to Assess the Results

After performing the Fukuda Stepping Test, place a small piece of tape on the floor along the front of your toes, and compare the angle of this line with your original line. If you have taken only 50 steps, then an angle of 30 degrees or more may indicate vestibular weakness to the side your body deviated.

If you performed the Fukuda Test for 100 steps, an angle greater than 45 degrees indicates single-sided vestibular weakness on the side to which your body turned while doing the test.

Reliability

There is some question amongst healthcare providers as to whether the Fukuda test is a reliable measure of vestibular function.

One study compared the Fukuda Stepping Test with another test called the Babinski-Weil Test. Subjects were non-disabled adults. The researchers concluded that the Fukuda test produced variable results in healthy test subjects, and was therefore not as reliable as the Babinski-Weil Test.

Another study found that the Fukuda Stepping Test was more useful when subjects wore inertial sensors on their lower legs, pelvis, sternum, and head.

Still, the Fukuda Stepping Test may be used by your physical therapist as an initial outcome measure to determine your vestibular, or kinesthetic awareness, function. Plus, it is a fun, simple test to do.

If you have dizziness or vertigo, then specific testing may be necessary to determine the cause of your problem. The Fukuda Stepping Test is a simple test to perform to monitor your current dizziness and to help your physical therapist find the right treatment for your dizziness.

Summary

The Fukuda Stepping test may be done at home or by a physical therapist. The test helps assess dizziness so your physical therapist can recommend the best treatment. The test involves stepping in place with your eyes closed for 100 steps and then measuring how much you turned during the test. The direction you turn can indicate which side of your body has vestibular weakness.

There is some question about whether or not the Fukuda Stepping Test is an accurate way to measure vestibular function. It's always a good idea to discuss this test and its results with your healthcare provider, and ask for additional tests if needed.

3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Ertugrul S, Soylemez E. Investigation of the functionality of Fukuda Stepping test in dizziness patients. Inkbb-forum: Elektronik kulak burun boğaz ve baş boyun cerrahisi dergisi. 2019;18(4).

  2. Paquet N, Taillon-Hobson A, Lajoie Y. Fukuda and Babinski-Weil tests: within-subject variability and test-retest reliability in nondisabled adultsJ Rehabil Res Dev. 2014;51:1013–1022, doi:10.1682/JRRD.2013.09.0206

  3. Belluscio V, Bergamini E, Iosa M, Tramontano M, Morone G, Vannozzi G. The iFST: An instrumented version of the Fukuda Stepping Test for balance assessment. Gait Posture. 2018;60:203-8. doi:10.1016/j.gaitpost.2017.12.010

By Brett Sears, PT
Brett Sears, PT, MDT, is a physical therapist with over 20 years of experience in orthopedic and hospital-based therapy.