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The Romberg test is part of the standard neurologic examination. The patient is asked to stand with feet together, hand on hips/sides and the eyes are closed. Vestibular and proprioceptive input is being tested.
This test is not very sensitive overall, but especially in concussed athletes.
Many concussed athletes are able to stand relatively stable despite their neurologic injury.
In order to better identify postural instability in concussion, we perform 3 separate balance tests (modified balance error scoring system, mBESS).
A) Romberg
B) Single leg stance
- Standing on the non dominant foot, the hip is flexed to approximately 30° and the is knee flexed to approximately 45°.
- NonDominant Leg: The nondominant leg is defined as the opposite leg of the preferred kicking leg
C) Tandem Stance
Have patient stand quietly with hands on hips
Have patient close eyes and start 20 second trial
If error occurs tell patient to return to start as quickly as possible
Examples of errors: opening eyes, lifting hands, falling out of position