Physical examination maneuver

Physical Exam

Tandem Gait

also known as Heel-to-toe walking
🎬
Video coming September 2026

How to Perform

Ask the patient to walk in a straight line placing the heel of one foot directly in front of the toes of the other with each step (heel-to-toe), for about ten steps. Watch for steps off the line, side-stepping, or loss of balance.

How to Interpret

Showing 1 of 5 findings

Vestibular Dysfunction

Tandem gait abnormal
Rule in
Somewhat helpful
Rule out
Somewhat helpful
Evidence:Limited

References

  • Cohen HS, et al. Laryngoscope. 2018. PMID: 29226324.
  • McGee S. Evidence-Based Physical Diagnosis. 6th ed. Philadelphia, PA: Elsevier; 2025.

Related Systems / Regions

Neurological

Related Bedside Tests

🎬Video coming Sept 2026
Gait Assessment
Rule in:IEAcute Neurologic Event or Severe Pain, IEAlcohol-related Cerebellar Degeneration, IEBilateral Hip Arthritis or Disease +20 more
Rule out:IEAcute Neurologic Event or Severe Pain, IEAlcohol-related Cerebellar Degeneration, IEBilateral Hip Arthritis or Disease +20 more
🎬Video coming Sept 2026
Heel-to-shin
aka Heel-knee-shin test
Rule in:IECerebellar Disease, IEMultiple Sclerosis, IESensory Ataxia (Posterior Column Dysfunction)
Rule out:IECerebellar Disease, IEMultiple Sclerosis, IESensory Ataxia (Posterior Column Dysfunction)
🎬Video coming Sept 2026
Finger-to-nose
Rule in:IECerebellar Disease, IEMultiple Sclerosis, IEUnilateral Cerebellar Lesion
Rule out:IECerebellar Disease, IEMultiple Sclerosis, IEUnilateral Cerebellar Lesion
🎬Video coming Sept 2026
Romberg Test
aka Romberg sign
Rule in:IESensory Ataxia (Posterior Column Dysfunction), IETabes Dorsalis, IEVestibular Dysfunction (Uncompensated) +1 more
Rule out:IESensory Ataxia (Posterior Column Dysfunction), IETabes Dorsalis, IEVestibular Dysfunction (Uncompensated) +1 more
🎬Video coming Sept 2026
Pronator Drift
Rule in:VHBrain Tumor, HStroke, NHUpper Motor Neuron Lesion +1 more
Rule out:VHStroke, MHBrain Tumor, NHUpper Motor Neuron Lesion +1 more
🎬Video coming Sept 2026
Ophthalmoscopy
aka Fundoscopy
Rule in:VHGlaucoma, SHDiabetic Retinopathy, MHIncreased Intracranial Pressure +13 more
Rule out:SHGlaucoma, MHDiabetic Retinopathy, MHIncreased Intracranial Pressure +13 more