Execution
- 1Position the patient standing with the feet together on a firm surface.
- 2Ensure the patient can safely stand unsupported before closing the eyes.
- 3Ask the patient to close the eyes and maintain the stance for approximately 10 to 30 seconds.
- 4Guard closely without providing support unless balance is lost.
- 5Record sway, stepping, grabbing support, or inability to maintain the stance.
Positive outcome
The test is positive when the patient cannot maintain the eyes-closed stance without compensatory movement, stepping, or support. In lumbar stenosis, a positive result may reflect proprioceptive or neurological compromise rather than stenosis itself. The result should be interpreted with gait, lower-limb symptoms, and neurological examination.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Katz et al. (1995) | NA | 40 | 91 | 4.4 | 0.66 |
| Cook et al. (2020) — systematic review | NA | NA | NA | NA | NA |
CommentModified Romberg is not specific to lumbar stenosis in a neurological sense; it identifies balance reliance on sensory input. Katz’s data suggest it may help rule in lumbar stenosis when positive, but sensitivity is low. Use it as a functional neurological sign rather than a stand-alone stenosis test.
Moderate Clinical Value