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Romberg Test: What It Is, How It Works, and What Results Mean
Key Takeaways
- The Romberg test is a quick and painless balance check that helps doctors look for coordination problems related to how your body senses its position in space. View all takeaways
The Romberg test helps doctors check for balance problems. Specifically, the test detects sensory ataxia (loss of coordination), which stems from issues related to proprioception. This is your sense of where your body parts are in space even when you are not looking at them.
Because the test is quick and noninvasive, doctors may recommend a Romberg test for children or adults if they show signs of ataxia. These signs can include unexplained unsteadiness, loss of balance, or frequent falls.
Read on to learn what the Romberg test involves, how it works, and when you or your child may need one. We’ll also cover what positive and negative results mean.
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What’s It Like To Take the Romberg Test?
The good news is the Romberg test is pretty quick and painless. You don’t have to do anything to prepare beforehand.
To take the Romberg test, your healthcare provider will ask you to keep your balance without holding on to anything. You’ll stand barefoot or in flat shoes with your feet together. Your arms may be down by your side or crossed in front of your chest.
You’ll do different parts of the test with your eyes open and your eyes closed. Each round of the test takes about 15 to 30 seconds.
As you stand, your provider will watch to see if you sway or show any balance issues. The idea is to find out whether you lose balance when closing your eyes.
Versions of the Romberg Test
Your healthcare provider may modify the Romberg test depending on what they’re looking for.
Sharpened Romberg Test
In the sharpened (or tandem) Romberg test, you place your feet with one in front of the other, heel to toe. Doctors may use a sharpened Romberg test to check for conditions that interfere with coordination. For example, this version of the test can highlight subtle balance problems related to decompression sickness in deep-sea divers.
Single-Legged Stance Test
Another version, called a single-legged stance test, may be helpful for people with Parkinson’s disease or age-related balance problems. You stand on one leg with your eyes open while a healthcare provider times you.
Typically, the goal is to last for at least one minute without losing balance. Usually, the test is done three times on each leg.
Walking Romberg Test
Sometimes, you do the Romberg test while walking. You walk for 5 meters (about 16 feet) with your eyes open. Then, you repeat the same walk with your eyes closed. Doing so can catch balance problems that occur only while you’re moving.
The walking Romberg test can be more sensitive than other versions of the test. It may help catch conditions that other versions miss.
Who Conducts the Romberg Test?
The Romberg test may seem simple, but it’s still considered a neurological exam. A neurologist or other specially trained healthcare provider administers the test in a medical exam room.
A qualified healthcare professional knows how to guide you through the Romberg test. They can safely spot you and interpret your subtle movements. They also know when to conduct more tests or refer you to other specialists.
What Does the Romberg Test Check For?
German neurologist Moritz Romberg developed the Romberg test in the 19th century to test for advanced syphilis, which can affect the brain. Today, the Romberg test continues to be a helpful tool for detecting other conditions.
Examples of health conditions that may warrant a Romberg test include:
- Brown-Sequard syndrome
- Friedrich ataxia
- Ménière’s disease
- Parkinson’s disease
- Posterior cord syndrome
- Wernicke’s syndrome
Friedreich ataxia is a rare inherited genetic disorder that affects the nervous system. Problems with balance may begin as early as age 5 or as late as after age 25. Besides unsteadiness and coordination problems, Friedreich ataxia can lead to trouble swallowing and speaking.
A Romberg test can help assess whether you have balance problems. But other tests, including genetic testing, are needed to confirm a diagnosis of Friedreich ataxia or another condition.
When Might You Need a Romberg Test?
If you have signs of balance problems, like frequent falls, your healthcare provider may suggest a Romberg test. For instance, older adults with a condition called normal pressure hydrocephalus, which can affect balance, may need the test.
You may also need a Romberg test if your doctor suspects you have a severe deficiency of the essential vitamin B12. People who follow a vegetarian diet or have digestive disorders are at higher risk for a B12 deficiency. It can take years of low B12 levels before they impact nerve pathways that control balance.
Any health conditions related to vision or the inner ear can impact your sense of balance. If you suspect or have a known history of these conditions, a Romberg test can be a quick and easy way to check your balance.
A Romberg test is also often a helpful first step to assess any unexplained symptoms, including:
- Poor coordination
- Difficulty doing daily tasks, like washing your face, without falling over
- Trouble moving around in the dark
The Romberg test helps rule out other causes of balance problems that are present all the time (not just when your eyes are closed). Examples include cerebellar dysfunction or cerebellar ataxia, which are related to the cerebellum, a structure in the back of the brain.
How To Understand Your Test Results
Another benefit of the Romberg test is that your results are ready right away. Once your healthcare provider watches how you balance, they can share what they think.
If Your Romberg Test Is Positive
Your test will be considered positive if you lose your balance when closing your eyes. Swaying your body or moving your foot to avoid falling are considered signs of a positive test. Doing so shows that you rely excessively on sight to stay balanced.
Under normal conditions, three systems work together to keep your balance. These include:
- Vision
- Vestibular system (your inner ear)
- Proprioception (your sense of your body in space)
If one system stops working, the other two compensate, or kick in, so you don’t lose your balance. For example, if you’re standing in the dark and can’t see, your vestibular system and proprioception will help keep you upright.
People who have the “Romberg sign” (a positive Romberg test) have issues related to the dorsal column, which connects the brain and spinal cord. The dorsal column is responsible for proprioception.
If Your Romberg Test Is Negative
Staying still and stable with your eyes closed during the Romberg test will give you a negative result. You may need other types of tests to understand what’s causing your symptoms.
What Causes a Positive Romberg Test?
Many different conditions can lead to a positive Romberg test. The one thing all these conditions have in common is that they involve the dorsal column.
If you notice any symptoms of poor balance, you should share them with your healthcare provider. Common symptoms associated with balance include:
- Blurry vision
- Dizziness
- Feeling like the room is spinning or you’re falling
- Feeling like you’re moving when you’re not
- Frequent falls or injuries
- Lightheadedness
Try to be specific when sharing your symptoms with your healthcare team. These details can provide clues about what’s behind your Romberg test result.
Join the Conversation
On MyAtaxiaTeam, people share their experiences with ataxia, get advice, and find support from others who understand.
Have you or a loved one had a positive Romberg sign during the Romberg test? Let others know in the comments below.
- Romberg Test — Cleveland Clinic
- The Romberg Sign: A Comprehensive Clinical Re-Evaluation for the Modern Neurologist — MedLink Neurology
- Friedreich Ataxia — National Institute of Neurological Disorders and Stroke
- Vitamin B12 — National Institutes of Health Office of Dietary Supplements
- Romberg Test — StatPearls
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