![]() ![]() It is important that the clinician does not exaggerate the perturbation. To make the Romberg test more difficult, the clinician can attempt to disturb the patient's balance with a perturbation.The literature does not report alternative methods for scoring a Romberg test.The Romberg test is scored by counting the seconds the patient is able to stand with eyes closed.When the patients closes his eyes, he should not orient himself by light, sense or sound, as this could influence the test result and cause a false positive outcome. For safety, it is essential that the observer stand close to the patient to prevent potential injury if the patient were to fall. The patient tries to maintain his balance. The clinician asks the patient to first stand quietly with eyes open, and subsequently with eyes closed.The arms are held next to the body or crossed in front of the body. The patient is asked to remove his shoes and stand with his two feet together.Note that instability can also be seen with lesions in other parts of the nervous system, such as the upper or lower motor neurons, or the basal ganglia.If there is a more severe proprioceptive or vestibular lesion, or if there is a midline cerebellar lesion causing truncal instability, the patient will be unable to maintain the standing position, even when the eyes are open.When visual input is removed, instability due to lack of vision can be teased apart from other sensory impairments.Only two of the three systems are needed to maintain balance. There are three sensory systems that provide input to the cerebellum to maintain truncal stability when the eyes are open: When the eyes are closed, the patient must rely on proprioception and vestibular function. ![]() When the person is standing with the eyes open, visual, proprioceptive, and vestibular information is used to maintain postural stability.The Romberg test, tests the function of: Dorsal Column Medial Lemniscal Pathway, the neural pathways by which sensory information from the peripheral nerves is transmitted to the cerebral cortex. ![]() It has been used in clinic for 150 years Purpose It is also proven to be sensitive and accurate means of measuring the degree of disequilibrium caused by central vertigo, peripheral vertigo and head trauma. Examples of conditions include:Subacute combined degeneration of spinal cord ( Vitamin B12 deficiency) Posterior cord syndrome (Posterior spinal artery infarction) Hemisection of spinal cord ( Brown Sequard syndrome) The Romberg test is an appropriate tool to diagnose sensory ataxia (a gait disturbance caused by abnormal proprioception involving information about the location of the joints). Specifically, the test assesses the function of the dorsal column of the spinal cord (the dorsal column is responsible for proprioception). The Romberg test is a test that measures a persons sense of balance. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |