Definition and Purpose of the Test
Romberg test is a screening measurement of the body’s sense of positioning or balance. A good balance requires a healthy function of spinal cord’s dorsal columns. This test is used by doctors in a neurological examination.
Cerebellar influence on the motor system is reflected in the balance control and coordination. A person needs at least two of the three senses to maintain balance when standing:
Proprioception is the unconscious perception of movement and the ability to know one’s body in a space. Sensation is the ability of a person to feel pressure, touch or vibration. Vision is the ability to see which is helpful in monitoring changes in balance.
Balance of a person is made possible even though one sense is absent. For example a person without the spatial orientation arising from stimuli within the body itself can still maintain balance with the use of the ability to see and ability to feel touch, pressure or vibration. If a person has a loss of balance a positive Romberg sign is interpreted.
- Ask the client to stand erect with feet together and arms at the side, first with eyes open then with both eyes closed for one full minute (some books state 20-30 seconds only).
- The examiner should stand near the client as a precaution to stop the client from falling over and assure the client that he or she will be supported if he or she begins to fall. A strong assistant is recommended for large subjects or clients. The examiner should stand ready to catch the client who has the risk of falling.
- The client with balance problem becomes more unsteady with his or her eyes closed.
- Watch the movement of the client’s body. A slight swaying is normal. A positive Romberg sign is noted when irregular swaying and toppling (falling over) occurs when the eyes are closed.
The first step of the procedure demonstrates that at least two of the three senses to maintain balance are intact or present. This is demonstrated by a good balance with the eyes open at the beginning of the test. The vision is removed in the next step by instructing the subject to close his or her eyes. If the other two senses of maintaining balance (proprioception and sensation) are intact the client will not fall. If prioception is defective, expect the client to sway irregularly and fall or topple.