Physical Exam

Romberg Test

also known as Romberg sign

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Video coming September 2026

How to Perform

Ask the patient to stand with the feet together and arms at the sides, first with the eyes open and then with the eyes closed for 30-60 seconds. Stand close enough to support the patient if balance is lost. A positive Romberg test is markedly increased swaying or loss of balance after the eyes are closed, with balance maintained while the eyes are open.

How to Interpret

Falls

Failure to stand with feet together and eyes open for 10 seconds in an older adult, predicting falls within one year

Rule in

Somewhat helpfulDerived CI

Rule out

Not helpfulDerived CI

Evidence:Limited

Lumbar Spinal Stenosis

Modified Romberg test abnormal (compensatory movements needed to hold a feet-together, eyes-closed stance for 10 seconds)

Rule in

Somewhat helpfulDerived CI

Rule out

Minimally helpfulDerived CI

Evidence:Limited

References

Anagnostou E, Kouvli M, Karagianni E, Gamvroula A, Kalamatianos T, Stranjalis G, Skoularidou M. Romberg's test revisited: changes in classical and advanced sway metrics in patients with pure sensory neuropathy. Neurophysiol Clin. 2024;54(5):102999. doi:10.1016/j.neucli.2024.102999. PMID 39042993. Khasnis A, Gokula RM. Romberg's test. J Postgrad Med. 2003;49(2):169-172. PMID 12867698. Lanska DJ, Goetz CG. Romberg's sign: development, adoption, and adaptation in the 19th century. Neurology. 2000;55(8):1201-1206. doi:10.1212/wnl.55.8.1201. PMID 11071500.
Zhang Q, Zhou X, Li Y, Yang X, Abbasi QH. Clinical Recognition of Sensory Ataxia and Cerebellar Ataxia. Front Hum Neurosci. 2021;15:639871. doi:10.3389/fnhum.2021.639871. PMID: 33867960.
Zhu Z, Gong H, Liu M, Zhang H, Yang L, Zhang X, Zheng H, Li Y, Li M, Li J. Diagnosing tabes dorsalis in HIV-negative patients: clinical features, neuroimaging, and laboratory insights in the modern antibiotic era. Infect Drug Resist. 2024;17:2567-2577. doi:10.2147/IDR.S464581. PMID 38919834.
Healton EB, Savage DG, Brust JC, Garrett TJ, Lindenbaum J. Neurologic aspects of cobalamin deficiency. Medicine (Baltimore). 1991;70(4):229-245. PMID 1648656.
von Bernstorff M, Obermueller T, Blum J, Hoxhallari E, Hofmann VM, Pudszuhn A. Accuracy of the bedside examination in patients with suspected acute unilateral peripheral vestibulopathy. Neurologist. 2024;29(4):238-242. PMID 38797929.
Katz JN, Dalgas M, Stucki G, et al. Degenerative lumbar spinal stenosis: diagnostic value of the history and physical examination. Arthritis Rheum. 1995;38(9):1236-1241. PMID: 7575718. Suri P, Rainville J, Kalichman L, Katz JN. Does this older adult with lower extremity pain have the clinical syndrome of lumbar spinal stenosis? JAMA. 2010;304(23):2628-2636. doi:10.1001/jama.2010.1833. PMID: 21156951.
Chu LW, Chi I, Chiu AYY. Incidence and predictors of falls in the Chinese elderly. Ann Acad Med Singapore. 2005;34(1):60-72. PMID: 15726221.
Romberg MH. Lehrbuch der Nervenkrankheiten des Menschen. Berlin: A. Duncker; 1846.

Research last updated September 9, 2026.