Romberg Test: Physical Exam
test of station (i.e., no movement) and not gait and provides information
related to the function of the cerebellum and vestibular system.
- Part of the complete neurological exam
- Assessment of the integrity of the dorsal column medial lemniscus
(responsible for carrying the afferent input of fine touch and conscious proprioception)
- Cerebellar or vestibular diseases
- Patient should stand with feet together on level ground, arms at their sides, and eyes open
- The examiner should stand facing the patient with their arms out, without touching them, to catch the patient if they fall
- Observe the patient for about 20 seconds
- Note any swaying or falling
- Ask the patient to close both eyes for 30 seconds
- Note the patient's ability to maintain an upright posture
- Minimal swaying occurs
- Failure to keep the eyes closed, a loss of balance
requiring the feet to move or patient falls. This suggests a problem with
- Able to stand upright with eyes open and minimal swaying
- A positive Romberg test indicates ataxia from dorsal column disease and impaired proprioception
- Normally, vision will compensate for the sensory loss
- Cerebellar and vestibular disease is indicated if patient cannot stand with their feet together regardless if their eyes are open or closed
- Diabetic neuropathy, due to lost position sense in the toes, may lead to a false-positive test
- A negative Romberg test does not rule out abnormal vestibular function
- The test is appropriate for patients up to the age of 80 years
- Bickley LS et al. Bates' Guide to Physical Examination and History Taking. 11th ed. Philadelphia, PA: Lippincott Williams & Wilkins. 2013; 718.
- Di Fabio RP. Sensitivity and specificity of platform posturography for identifying patients with vestibular dysfunction. Phys Ther. 1995;75(4):290-305.
- Orient, JM. Sapira's Art and Science of Bedside Diagnosis. 4th ed. Philadelphia, PA: Lippincott Williams & Wilkins. 2010;556-557.