1 Before you use it
What it is
A dorsal column screen, not a balance test — and the distinction is the whole point.
Stand with feet together, arms by the side, eyes open — then eyes closed. A positive test is a marked increase in sway or loss of balance only after the eyes close.
When to reach for it
Whenever cervical myelopathy is on your list — clumsy hands, a change in handwriting, buttons, a wide-based or unsteady gait, bilateral symptoms, or an older patient with neck pain and something that doesn't fit.
Also in the CAD/VBI screen, as part of a neurological examination rather than as a standalone.
Patterns it serves · 2
2 Giving it
Scoring
Not scored. Positive = stable with eyes open, unstable with eyes closed.
Someone who is unsteady with their eyes open has not produced a positive Romberg — they have produced a cerebellar or vestibular finding, which is a different referral.
What it doesn’t measure
It does not test the cerebellum or the vestibular system — those are what an eyes-open finding points to. It does not localise a level. And it does not rule anything out.
3 Reading the score
Interpreting it
No verified accuracy figure exists in our library for this test and none is printed here.
Its value on an MSK placement is narrow and specific: it belongs to the myelopathy screen, alongside gait observation, Hoffmann's sign, hyperreflexia and clonus. One positive finding in isolation means little; the cluster is what should move you.
Is the change real?
Student trap. Calling it positive because they wobbled with their eyes open. That is not a Romberg — and it points somewhere else entirely.
Official source: null. We don't host the form.
This is a learning tool. It does not diagnose patients and does not replace your clinical educator.
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