What is the Romberg position and what diseases can this test indicate?

What is Romberg's pose?

The Romberg position is a simple diagnostic tool that can be used by a physician to check the patient's sense of balance and determine neurological disorders.

The subject is asked to stand up straight, join his legs, extend his arms in front of him or cross them on his chest and close his eyes. If he manages to stand like this for 60 seconds without falling or leaning to the sides, the test is considered negative; if not, it is considered positive.

Several body systems are responsible for the sense of balance: visual (vision), vestibular and proprioceptive. The latter represents signals from nerve endings in the skin, muscles and joints that are transmitted along the spinal cord to the brain. Thanks to this “muscle feeling” we understand how our body is located in space, how it moves and what it feels.

If a person has impaired proprioceptive system function, for example due to spinal cord damage, vision and the vestibular system can compensate for the deficiency. Since the Romberg test is performed with the eyes closed, it can be used to identify problems specifically with the “muscle sense”.

This test was invented back in the 40s of the 19th century by the German professor Moritz Romberg and was used for patients with tertiary syphilis, or tabes dorsalis. In this form of the disease, people experience damage to the back of the spinal cord, which is responsible for proprioception, and begin to have problems with gait and other body movements.

Today syphilis successfully treated before it progresses to an advanced stage, and the Romberg position is used as a method for diagnosing other neurological disorders.

What problems might a positive Romberg test indicate?

The Romberg test may be prescribed to a person who complains of poor balance, dizziness, and falling. A positive result may indicate the following: Problems with health:

• Parkinson's disease — disease brain, in which motor function is impaired. Patients experience involuntary movements and muscle contractions, tremors, shuffling gait, and postural instability.
• Friedreich's ataxia is a hereditary disease that occurs due to mutations in genes and can manifest itself both in childhood and after 30–40 years. In patients, movements and gait are impaired, muscle weakness increases, and problems with hearing, vision and speech arise.
• Vitamin B12 deficiency - impaired myelination of spinal cord nerves, deterioration of conductivity and impaired proprioception.
• Normal pressure hydrocephalus - problems with the circulation of cerebrospinal fluid, in which walking disturbances are observed, dementia and urinary incontinence.
• Wernicke's syndrome - insufficient consumption and absorption of thiamine, often occurring against the background of severe alcoholism. Symptoms may include gait disturbance, disorientation, stupor, and confusion.
• Brown-Séquard syndrome - dysfunction of the spinal cord, for example due to injury or tumor.
• Meniere's disease - excessive accumulation of fluid in the inner ear, which causes dizziness, nausea, noise in ears.

What does the Romberg pose look like?

The subject takes off his shoes and stands up straight, puts his feet together, stretches his arms forward or crosses them on his chest.

He needs to stay in this position for about 30 seconds with his eyes open. Then, at the doctor’s command, he must close them and hold on for another 30–60 seconds. At this time, the neurologist evaluates whether the person is leaning forward, backward, or to the sides, and if so, how much.

If the patient sways, falls, or puts his foot down to avoid this, the Romberg test is considered positive. If this happens, your doctor may order additional tests to determine the cause of your balance problems.

There are also several modifications of the test:

1. Pointed Romberg test. A person places his feet on the same line so that the toe of one touches the heel of the other. This test is carried out to identify problems with coordination in people recovering from decompression.
2. Single leg test. A man stands with his eyes open on one leg. You need to hold out for one minute on each and repeat this three times. This test is used for older people and patients with Parkinson's disease and helps determine how stable their posture and body control are.
3. Test on foam rubber. This option helps reduce the influence of proprioception and tests the vestibular system.

Is it worth trying Romberg pose on your own?

The Romberg test can be done at home, especially if you have someone nearby to support you if you fall. However, this won't make much sense.

In modern medicine, the Romberg position is used only as one of the diagnostic tools, and then additional tests are prescribed to clarify the diagnosis.

For this reason, it only makes sense to take the test if you need extra motivation to sign up. neurologist. You definitely won’t be able to diagnose yourself.