Which sign would the nurse document as being positive after observing that the client sways with eyes closed?

The Romberg test is a test that measures your sense of balance.

It’s typically used to diagnose problems with your balance, which is composed of your visual, vestibular (inner ear), and proprioceptive (positional sense) systems during a neurological exam.

Specifically, the test assesses the function of the dorsal column in your spinal cord. The dorsal column is responsible for proprioception, or your sense of your body’s movement and position.

A law enforcement officer may also use a modified Romberg test to check a person’s sobriety. For example, it might be done to determine if a person is under the influence of alcohol.

The test is also known as the:

  • Romberg’s sign
  • Romberg’s maneuver

Your health care provider will likely use a Romberg test if you’re experiencing imbalance, dizziness, and falls during everyday activities.

To learn more about the Romberg test and what it involves, read on. We’ll explain what to expect, what the results mean, and common variations of the test.

When used for medical purposes, the Romberg test will take place in your health provider’s office. You don’t need to go to the hospital.

The Romberg test consists of two stages. Here’s what you can expect:

  1. You’ll be asked to remove your shoes. You’ll also be asked to stand with your feet together on a flat, hard surface.
  2. The examiner will ask you to cross your arms in front of your body or place them at your sides.
  3. You’ll be asked to stand still and keep your eyes open for about 30 seconds. Your examiner will observe your body movement and balance. This completes the first stage.
  4. Next, you’ll be asked to close your eyes and stand for 30 seconds. Your examiner will check your body movement and balance. This completes the second stage.

You’ll perform the test without any physical support. This means your provider won’t hold your shoulders or place you against a wall.

Additionally, some examiners might have you perform each stage for up to 60 seconds.

It’s worth noting that the Romberg test will look different if it’s done by a law enforcement official. You won’t have to remove your shoes and you may not have to close your eyes.

The Romberg test can be performed in various ways. Providers might also make their own modifications and use different postures, foot positions, or duration.

Common variations include the following:

Sharpened Romberg test

The sharpened Romberg test, also called the tandem Romberg test, uses a different foot position. It’s often used for people who are at risk of falling due to old age or a neurological disorder.

In this version, you’re asked to place one foot in front of the other. The heel of your front foot should touch the toes of your back foot.

Either foot can be placed in the front position. Your provider might have you switch feet and repeat the test to see if your balance changes.

Single leg Romberg test

The single leg Romberg test involves standing on one leg. You may be asked to switch feet so your provider can assess any differences.

The results of a Romberg test are determined by your body movements while balancing. Here’s what each result means:

Romberg’s test positive result

If you sway and fall during the test, your result is positive.

A positive Romberg test may indicate an issue with your:

  • sensory system
  • vestibular system
  • proprioceptive system

These systems help you stay balanced while standing upright. But if there’s a problem with one of these systems, you may be unable to maintain balance.

A positive test result might be caused by other disorders. Examples include:

  • intoxication (alcohol or drugs)
  • metabolic disorders
  • vitamin B12 deficiency
  • copper deficiency
  • hyperzincemia
  • hydrocephalus (fluid buildup in the brain)
  • Parkinson’s disease
  • Friedreich ataxia
  • Tabes dorsalis (a form of neurosyphilis)
  • Wernicke’s syndrome
  • Ménière’s disease
  • central or peripheral vertigo
  • head injury

Negative Romberg’s test results

A Romberg test is negative if you have minimal swaying during the test. It also means you’re able to stay stable with your eyes closed or open.

This indicates that your vestibular or proprioceptive symptoms may not be related to balancing issues.

It’s possible to get dizzy or fall during the test. Therefore, your health care provider should:

  • guard you
  • watch your movements closely
  • remove nearby objects

These precautions will ensure that you stay safe during the test.

The Romberg test, or Romberg sign, is a simple test that assesses your ability to stay balanced. Your health care provider might use the test if you have dizziness or falling. A positive Romberg test occurs if you lose balance during the procedure.

Generally, the Romberg test is done to evaluate neurological conditions like head injuries or Parkinson disease. The examiner should always prioritize safety and prevent falls, which may lead to injury.

What is a positive Romberg sign?

The Romberg sign is an easily administered, no-equipment, bedside physical exam maneuver used since its description in the 19th century to help diagnose tabes dorsalis and dorsal column and proprioceptive dysfunction. A positive test is the inability to maintain an erect posture over 60 seconds with eyes closed.

What causes Romberg positive?

Positive Romberg Romberg's test is positive in conditions causing sensory ataxia such as: Vitamin deficiencies such as Vitamin B. Conditions affecting the dorsal columns of the spinal cord, such as tabes dorsalis (neurosyphilis), in which it was first described.

What causes loss of balance when eyes are closed?

A tendency to sway and fall with eyes closed is suggestive of a spinal disorder (e.g. polyneuropathy). A tendency to sway and fall that is already evident with eyes open is suggestive of dizziness of vestibular or cerebellar origin.

What system is likely affected with a positive Romberg sign?

A positive Romberg test may indicate an issue with your: sensory system. vestibular system. proprioceptive system.