Clinical Assessment: Romberg Test
Ensure a safe testing environment with a spotter present. Document whether balance is maintained with eyes open and compare to eyes-closed stance. Always integrate findings into broader neurological and fall-risk assessment.
Romberg Test
A clinical neurological test evaluating proprioception and balance. Assesses the sensory (afferent) component of balance rather than the cerebellar (motor) component. Described by Moritz Romberg (1853).
Administration protocol:
- Ask the patient to stand with feet together, arms at sides. Observe balance for 30 seconds with eyes open.
- Without moving the feet, instruct the patient to close both eyes. Observe for 30 seconds.
- Stand behind the patient, ready to support if needed.
- Compare balance quality with eyes open versus eyes closed.
Interpretation reference
Negative Romberg (Normal)
Patient maintains balance with feet together and eyes closed, with only minimal swaying.
Intact proprioception and vestibular function. Normal sensory integration.
Document as Romberg negative. No further balance-specific workup indicated based on this test alone.
Positive Romberg
Patient sways significantly, loses balance, or needs to step out with eyes closed but was stable with eyes open.
Suggests deficiency in proprioception (dorsal column dysfunction) or vestibular function. Not indicative of cerebellar ataxia, which presents with eyes open.
Notify provider. Assess for peripheral neuropathy, vestibular disorder, B12 deficiency, or cervical myelopathy. Refer to physiotherapy and neurology as indicated. Fall-prevention measures.