The Romberg balance test is a 150 year old, very basic, “standing with eyes closed test”. The duration of the test, including instructions, setup, and recording data is about 4 to 12 minutes. Duration depends upon the number of restarts after a positive test result. (Loss of balance is positive.)
Testing with our VNG System is more scientific, comprehensive, and requires less supposition.
A Romberg balance test can be useful in measuring the degree of disequilibrium caused by the central vertigo, peripheral vertigo and head trauma. It is also useful to identify functional elements such as patients who sway a great deal, but do not fall. Clinicians can use it to diagnose sensory ataxia, a gait disturbance caused by abnormal proprioception involving information about the location of the joints. It demonstrates the effects of posterior column disease upon human upright postural control.
There are variations of the Romberg Test stance. In this example, we’ll run through the most basic. Here’s how it works and how to measure positive or negative results in the patient.
- Ask the patient to remove their shoes.
- With open eyes, the patient should then stand with their feet together, and their arms folded in front of them.
- The patient should stare at a point that is approximately 1 meter away.
- Time this eyes open stance for thirty seconds.
- With closed eyes, the patient should stand the same way: feet together; arms folded in front of their abdomen.
- Time this eyes closed stance for thirty seconds.
- Record how long the patient can maintain balance within the thirty second duration of each segment.
Romberg Test Positives
A positive is what’s known as the Romberg Sign. A fall is recorded if the patient:
- opens their eyes
- takes a step
- unfolds their arms
A positive test may present itself in patients with a peripheral neuropathy, or those who are over 65 years old having acute vestibular loss.
Repeat the Romberg Test after a “fall” is recorded.
Romberg Balance Test Data
The Romberg Test is positive if the patient cannot keep their balance with their eyes closed.
Age related normative data is available for this Romberg Test.
Stance related normative data is available for this test. If the clinician has the patient stand with feet at shoulder width, different norms apply.
“Good balance depends on good motor control abilities but also on feedback inputs regarding body position and velocity at any time. These inputs come from three systems: vision, proprioception, and vestibular sensation16.
In normal individuals, these systems share the task of maintaining standing on a firm surface as follows: proprioceptive system (70%), vestibular system (20%), and visual system (10%)17. It can be concluded that the research of traditional Romberg sign better discerns proprioceptive problems than vestibular affections.”
— http://www.scielo.br/scielo.php?pid=S0004-282X2011000700021&script=sci_arttext “Rethinking the neurological examination I: static balance assessment”