Romberg's Test: Assessing Balance & Proprioception

Romberg's Test is a neurological assessment used to evaluate the dorsal columns of the spinal cord (proprioception). It helps differentiate between sensory ataxia and cerebellar ataxia by removing visual input.

[Image of Romberg's Test procedure]

1. Purpose

The primary purpose of Romberg's Test is to **assess the dorsal columns** of the spinal cord, which are responsible for proprioception (position sense). It helps differentiate between:

• Sensory Ataxia: Balance loss due to proprioceptive issues (positive Romberg).
• Cerebellar Ataxia: Balance loss due to cerebellar dysfunction (negative Romberg, because they sway even with eyes open).

2. How to Perform

Safety Warning: The examiner must stand close to the patient with arms ready to catch them if they fall.

1. The patient stands with feet together (medial malleoli touching) and arms crossed or at their sides.
2. Stage 1 (Eyes Open): The patient holds this position for 30 seconds. The examiner observes for sway.
3. Stage 2 (Eyes Closed): The patient closes their eyes and attempts to maintain balance for 30 seconds.

3. Positive & Negative Sign

Positive Sign (Test is POSITIVE):
This indicates Sensory Ataxia (Dorsal Column Dysfunction).

• The patient is stable with eyes open.
• The patient loses balance (sways significantly or takes a step to correct) ONLY when eyes are closed. This means they rely entirely on vision for balance.

Negative Sign (Test is NEGATIVE):
The patient maintains balance with minimal sway with both eyes open and eyes closed.

Note: If the patient sways significantly even with eyes OPEN, this is often a sign of Cerebellar Ataxia, not a positive Romberg.