Execution
- 1Position the patient standing near a support surface and guards closely.
- 2Ask the patient to stand with feet together and eyes open, then eyes closed.
- 3Progress to tandem stance or sharpened Romberg when safe.
- 4Time the stance and observe sway, stepping, falling, or need for upper-limb support.
- 5Compare eyes-open and eyes-closed performance.
Positive outcome
A positive Romberg pattern is stable stance with eyes open but excessive sway, step, or loss of balance with eyes closed. This suggests impaired somatosensory or vestibular contribution to balance rather than a specific vestibular diagnosis. Inability to stand with eyes open is not a classic Romberg sign and suggests cerebellar, motor, or severe balance impairment.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Agrawal et al. (2011) | population vestibular/balance association study | NA | NA | NA | NA |
CommentRomberg and tandem Romberg are useful balance screens, but they do not localize the lesion. They are influenced by neuropathy, vision, age, strength, fear, footwear, and musculoskeletal pain. Use them as part of a vestibular and neurological battery, not as a diagnosis.
Low Clinical Value