Hi Charlie! Yes, a positive Romberg is when the patient sways a lot, has to take a step to prevent themselves from falling, or falls. A negative Romberg test is when the patient remains steady or there is only very minor swaying. Hope this helps!
Hi, just wanna to give some input here. Romberg test is actually done to see presence of sensory ataxia not cerebellar dysfunction. It means patient will have body imbalance when they close their eyes due to loss of visual compensation. In cerebellar dysfunction the unsteadiness are present with both open and closed eyes. So romberg is actually negative in case of cerebellar damage 😊
Thank you for pointing this out. After consulting my original nursing resources and not coming to any findings other than what's in the video, I did a little deeper digging and found this helpful article that distinguishes between the vestibular system, visual system and proprioceptive system when it comes to balance. Here's what it says: "The maintenance of human balance mainly depends on the coordination of vestibular system, visual system and proprioceptive system (Maurer et al., 2001). In an upright position, a normal person can stand steadily when the eyes open and close; but when two or more systems are damaged, the human body will not be able to maintain balance. For example, when a patient is suffering from Sensory Ataxia, the visual system can provide compensation information when the eyes are open, so the patient can remain upright and stable; Visual compensation would disappear when the eyes are closed, patients will not be able to maintain upright stability. This is the theoretical basis of Romberg’s sign has become an important part of modern neurological clinical examination (Lanska, 2002). In Romberg’s test, the patient’s feet are closed and arms are placed on both sides of the body. Standing is divided into two stages: opening eyes and closing eyes. Firstly, the patients are allowed to open their eyes and stand for a certain time, then the patients close the eyes and stand for a while, and the patients are observed: whether their body have obvious shaking in two stages. As long as there is a stage in which the patient shows standing instability, the Romberg’s sign is positive (Pearce, 2005). Before carrying out Romberg’s test, lower limb diseases or other factors should be excluded. In order to prevent the patient from falling down, protective pads should be laid around the patient’s standing and medical staff should also take care of the patients. During the experiment, normal people can keep their body stable whether they open or close their eyes. Considering age, gender and other factors, the normal performance of the minimum standard should be that body balance can be maintained for 6 s during eye closure (Hain and Cherchi, 2017). For sensory ataxia and cerebellar ataxia, their Romberg’s signs are both positive, but there are some differences. The patient can keep standing steady during the eye-opening phase, and standing unsteadily, wobbling, or even falling in the closed eye phase (Franchignoni et al., 1984), as shown in Figure 1. The cerebellar ataxia patients were unstable in the stage of closing eyes and opening eyes, and tend to tilt toward the diseased side of cerebellum (Cazzato et al., 2016), as shown in Figure 2. Romberg’s test is a simple and sensitive clinical trial, the different performances of normal people, sensory ataxia patients and cerebellar ataxia patients in the Romberg’s test are given in Table 1." Here is the link to the full article for reference: www.frontiersin.org/journals/human-neuroscience/articles/10.3389/fnhum.2021.639871/full
@@NursingSchoolExplainedAccording to oxfords handbook of neurology, Romberg test is positive in sensory and vestibular ataxia. In patients with severe cerebellar ataxia , they cannot stand steady even with eyes open, you dont need a specific test for that. Rombergs test is to differentiate causes of ataxia by eliminating visual compensation, and its only when patient can stand still with eyes open but not closed that it can be termed ‘positive’ .
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Romberg Test:
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Gait Assessment:
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Finger-to-Nose Test:
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Assessment of Peripheral Sensory Function:
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Head-to-toe vs. Focused Assessment:
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positive test when there is an issue and negative test when gait is fine??? would you explain this
Hi Charlie! Yes, a positive Romberg is when the patient sways a lot, has to take a step to prevent themselves from falling, or falls. A negative Romberg test is when the patient remains steady or there is only very minor swaying. Hope this helps!
I was expecting a positive romberg sign.
Is it positive in cerebellar damage ?
Yes!
Hi, just wanna to give some input here. Romberg test is actually done to see presence of sensory ataxia not cerebellar dysfunction. It means patient will have body imbalance when they close their eyes due to loss of visual compensation. In cerebellar dysfunction the unsteadiness are present with both open and closed eyes. So romberg is actually negative in case of cerebellar damage 😊
@@NursingSchoolExplained Wrong. It does not test cerebellar damage.
Thank you for pointing this out. After consulting my original nursing resources and not coming to any findings other than what's in the video, I did a little deeper digging and found this helpful article that distinguishes between the vestibular system, visual system and proprioceptive system when it comes to balance. Here's what it says:
"The maintenance of human balance mainly depends on the coordination of vestibular system, visual system and proprioceptive system (Maurer et al., 2001). In an upright position, a normal person can stand steadily when the eyes open and close; but when two or more systems are damaged, the human body will not be able to maintain balance. For example, when a patient is suffering from Sensory Ataxia, the visual system can provide compensation information when the eyes are open, so the patient can remain upright and stable; Visual compensation would disappear when the eyes are closed, patients will not be able to maintain upright stability. This is the theoretical basis of Romberg’s sign has become an important part of modern neurological clinical examination (Lanska, 2002).
In Romberg’s test, the patient’s feet are closed and arms are placed on both sides of the body. Standing is divided into two stages: opening eyes and closing eyes. Firstly, the patients are allowed to open their eyes and stand for a certain time, then the patients close the eyes and stand for a while, and the patients are observed: whether their body have obvious shaking in two stages. As long as there is a stage in which the patient shows standing instability, the Romberg’s sign is positive (Pearce, 2005). Before carrying out Romberg’s test, lower limb diseases or other factors should be excluded. In order to prevent the patient from falling down, protective pads should be laid around the patient’s standing and medical staff should also take care of the patients. During the experiment, normal people can keep their body stable whether they open or close their eyes. Considering age, gender and other factors, the normal performance of the minimum standard should be that body balance can be maintained for 6 s during eye closure (Hain and Cherchi, 2017). For sensory ataxia and cerebellar ataxia, their Romberg’s signs are both positive, but there are some differences. The patient can keep standing steady during the eye-opening phase, and standing unsteadily, wobbling, or even falling in the closed eye phase (Franchignoni et al., 1984), as shown in Figure 1. The cerebellar ataxia patients were unstable in the stage of closing eyes and opening eyes, and tend to tilt toward the diseased side of cerebellum (Cazzato et al., 2016), as shown in Figure 2. Romberg’s test is a simple and sensitive clinical trial, the different performances of normal people, sensory ataxia patients and cerebellar ataxia patients in the Romberg’s test are given in Table 1."
Here is the link to the full article for reference: www.frontiersin.org/journals/human-neuroscience/articles/10.3389/fnhum.2021.639871/full
@@NursingSchoolExplainedAccording to oxfords handbook of neurology, Romberg test is positive in sensory and vestibular ataxia. In patients with severe cerebellar ataxia , they cannot stand steady even with eyes open, you dont need a specific test for that. Rombergs test is to differentiate causes of ataxia by eliminating visual compensation, and its only when patient can stand still with eyes open but not closed that it can be termed ‘positive’ .
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Oh good. I feel better