"like the arms of a pendulum swaying to and fro......"
dr.prasanth, kerala ayurveda hospital
Rombergs test is a test used by doctors & physical therapists in a neurological examination and also as a test for drunken driving.
Atleast three senses needed to maintain balance while standing :
1.proprioception-the ability to know ones body in space
2.vestibular function-ability to know ones head position in space
3.vision-which can be used to monitor changes in body position
A patient who has problems with proprioception can still maintain balance by using vestibular function and vision.Rombergs test is a test for positioning. Proprioception requires healthy functioning of the dorsal columns of the spinal cord.
Used to investigate cases of loss of motor cordination (ataxia).
Ataxic patient with rombergism-sensory ataxia
Ataxic patient with no rombergism-ataxia is cerebellar in nature, local cerebellar dysfunction
Indicator for possible alcohol or drug impaired driving & neurological decompression sickness.
When used to test impaired driving, test is performed with subject estimating 30 seconds in his head.Used to gauge the subjects internal clock and can be an indicator of stimulant or depressant use.
Rombergism-if the patient sways or falls while the patients eyes are closed in a standing position,
Proprioception and vestibular input are needed for position and sense of balance.
Vision is cut due to closed eyes in Rombergs test.
Vestibular disorder (labyrinthine)
Sensory disorder (proprioceptive dysfunction)
PHYSIOLOGY OF BALANCE
Maintaining balance while standing in the stationary position relies on intact sensory pathways, sensori motor integration centres and motor pathways.
The main sensory inputs are :
Proprioception(joint position sense)
Vision
Vestibular apparatus
Sensori motor integration-cerebellum & dorsal column-medial leminiscus tract
Motor pathway-corticospinal(pyrimidal tract) & medial & lateral vestibular tract
FIRST STAGE OF TEST(SENSORI ORGANISATION TEST)
atleast two of three sensory pathways is intact
-sensori motor integration
-motor pathway functioning
stand unsupported with eyes open and hands on hips for 30 seconds
if patient takes a step or removes a hand from hip, the timer is stopped
patient may take two attempts to complte 30s
SECOND STAGE OF TEST
visual pathway removed by closing the eyes
balance maintained if JPS & VP are intact
if JPS is defective two of sensory input absent patient sway then fall
2 attempts to complete 30s
ROMBERGISM
sensory ataxia
vitamin b12 deficiency(cobalamin)
dorsal column of spinal cord such as tabes dorsalis(neurosyphilis)
sensory peripheral neuropathies
chronic inflammatory demyelinating polyradiculoneuropathy
friedreichs ataxia
Not a test of cerebellar function
Cerebellar ataxia , the patient is not able to balance beyond first step
Test of JPS and pathways function
Rombergism 90% sensitive for lumbar spinal stenosis.
dr.prasanth, kerala ayurveda hospital
Rombergs test is a test used by doctors & physical therapists in a neurological examination and also as a test for drunken driving.
Atleast three senses needed to maintain balance while standing :
1.proprioception-the ability to know ones body in space
2.vestibular function-ability to know ones head position in space
3.vision-which can be used to monitor changes in body position
A patient who has problems with proprioception can still maintain balance by using vestibular function and vision.Rombergs test is a test for positioning. Proprioception requires healthy functioning of the dorsal columns of the spinal cord.
Used to investigate cases of loss of motor cordination (ataxia).
Ataxic patient with rombergism-sensory ataxia
Ataxic patient with no rombergism-ataxia is cerebellar in nature, local cerebellar dysfunction
Indicator for possible alcohol or drug impaired driving & neurological decompression sickness.
When used to test impaired driving, test is performed with subject estimating 30 seconds in his head.Used to gauge the subjects internal clock and can be an indicator of stimulant or depressant use.
Rombergism-if the patient sways or falls while the patients eyes are closed in a standing position,
Proprioception and vestibular input are needed for position and sense of balance.
Vision is cut due to closed eyes in Rombergs test.
Vestibular disorder (labyrinthine)
Sensory disorder (proprioceptive dysfunction)
PHYSIOLOGY OF BALANCE
Maintaining balance while standing in the stationary position relies on intact sensory pathways, sensori motor integration centres and motor pathways.
The main sensory inputs are :
Proprioception(joint position sense)
Vision
Vestibular apparatus
Sensori motor integration-cerebellum & dorsal column-medial leminiscus tract
Motor pathway-corticospinal(pyrimidal tract) & medial & lateral vestibular tract
FIRST STAGE OF TEST(SENSORI ORGANISATION TEST)
atleast two of three sensory pathways is intact
-sensori motor integration
-motor pathway functioning
stand unsupported with eyes open and hands on hips for 30 seconds
if patient takes a step or removes a hand from hip, the timer is stopped
patient may take two attempts to complte 30s
SECOND STAGE OF TEST
visual pathway removed by closing the eyes
balance maintained if JPS & VP are intact
if JPS is defective two of sensory input absent patient sway then fall
2 attempts to complete 30s
ROMBERGISM
sensory ataxia
vitamin b12 deficiency(cobalamin)
dorsal column of spinal cord such as tabes dorsalis(neurosyphilis)
sensory peripheral neuropathies
chronic inflammatory demyelinating polyradiculoneuropathy
friedreichs ataxia
Not a test of cerebellar function
Cerebellar ataxia , the patient is not able to balance beyond first step
Test of JPS and pathways function
Rombergism 90% sensitive for lumbar spinal stenosis.
