Greetings, my dear readers! Surely many of you have wondered whether it is possible to check for yourself whether the nervous system is functioning normally? Are there any violations of certain functions? I’ll answer right away - you can check it yourself, and there is even a special Romberg test for this. At its core, the Romberg position is a simple examination that is accessible to everyone at home. You will learn more about what it is, why and who needs it and how to carry it out from this material.
What is the Romberg pose?
The pose was developed by the famous neurologist and professor at the University of Berlin Moritz Heinrich Romberg. The purpose of the new development was to identify disorders and disorders in the brain and spinal cord. Actually, this test was named after the professor.
To carry it out, the person being examined is placed in a specific position. And if he is unable to maintain stability in it, then this may be a clear sign of violations. This examination is usually performed in neurology, in several approaches.
And if during it tremor (shaking, hesitation) or instability (staggering) appears, then the person is referred for additional examination. And after that, an accurate diagnosis is made.
The technique has many advantages, is suitable for everyone and does not require costs or equipment. Anyone can conduct it, at any moment, at home. In addition, the Romberg pose is a good opportunity, along with diagnosing the functioning of the nervous system, to identify problems in other areas. And then determine their reasons.
An interesting point is that it is this position that is used by inspectors on the roads in modern realities. After all, it makes it possible to determine whether the driver is sober or whether he is intoxicated.
Symptoms
Such studies are resorted to when:
- dizziness (this symptom can be a sign of various pathologies, for example, with damage to the labyrinth, patients can often describe in detail the nature of dizziness, including indicating the exact direction of rotation of objects, position of the head and body, etc.);
- vegetative symptoms (in addition to dizziness, the subjects complain of nausea, which can be replaced by vomiting, increased sweating, pale skin, changes in pulse rates, etc.);
- spontaneous nystagmus (one of the most important symptoms, represents oscillatory movements of the eyeballs, which can be fast or slow, develops due to a disruption of impulses coming from the labyrinths to the nerves).
Along with this, typical markers of dysfunction of the vestibular apparatus are imbalance and unsteady gait.
What does swaying in the Romberg pose reveal?
The patient's inability to maintain stability in this position indicates disturbances in certain areas of the brain. The neurology of such deviations can be different. That is, swaying and loss of balance can be caused by the following neurological reasons:
- hysteria;
- Meniere's disease and inflammatory diseases of the inner ear;
- traumatic brain injuries;
- meningitis (bacterial inflammation of areas of the spinal cord and brain);
- neuroses;
- encephalitis;
- consequences of ischemic or hemorrhagic stroke;
- cervicogenic dizziness (one of the causes of salt deposition in the cervical spine);
- lesions (infectious and traumatic inclusive) of the spinal cord.
- psychiatric illnesses.
Carrying out the test for children makes it possible to identify nervous system problems at their early stages.
What is the diagnosis?
The main objective of the Romberg test is to determine dysfunctions of the organs that are responsible for balance. The systems that are responsible for human balance include:
- vestibular apparatus;
- proprioception system;
- brain functions.
Diagnostics makes it possible to determine whether there are abnormalities in the nervous system, possible disturbances in the functioning of the spinal cord, or whether there are disturbances in the functions of the vestibular apparatus.
Initially, there was only one version of the Romberg pose; now different versions are used. Stopwatches are also used in diagnostics, which allow you to obtain a quantitative assessment of the result.
With this technique, the patient closes his eyes, which allows him to determine how great the influence of vision is in maintaining balance, and how well other organs cope with this function.
Execution technique and various options
The technique of performing the Romberg pose is simple and accessible. Here is a simple way to do it step by step:
- The person being examined should stand straight, with his toes slightly apart, while keeping his heels together.
- Distribute your weight, keep your back straight.
- Next, he extends his arms straight forward, palms facing the floor, fingers spread.
- Then he closes his eyes and stands quietly.
An ordinary, healthy child should normally stand like this for 15 seconds.
This is the average. Since each age has its own time frame, which is reflected below.
Of course, for an adult this norm is higher. And on average it can range from 15 seconds to one minute.
The norm depends on age, health status, concomitant ailments and problems.
If the patient has passed the test, but the specialist still suspects violations, he is offered a more complicated variation of the test. It differs from a simple one in that the feet need to be placed on one line, one forward, the other slightly back. Hands are raised the same way. Deviations (staggering, instability) may indicate disorders or illnesses. Or about physical inactivity and detraining.
The most difficult option is when a person stands on only one leg, tucking the other foot to the knee. It is used if the previous options did not help make the picture of the patient’s disorders extremely clear.
Attention! If you plan to perform the test at home, or in other settings without medical personnel, it is extremely important to have someone who can help you if you lose your balance.
This is especially important if the person being examined already has serious health problems. For example, a tendency to faint, surges in blood pressure, physical weakness, dizziness.
Types of diagnostics
To diagnose vestibular function in otolaryngology, the following types of studies are used:
Romberg pose
Named after the German professor of internal medicine MH Romberg, this position involves the subject taking a vertical position, feet together, arms extended forward, eyes closed.
The method allows you to identify changes in balance when vision is turned off. Depending on the causes and severity of the violations, a person in this position begins to stagger and may even fall. In the latter case, we are talking about the so-called Romberg symptom, which indicates possible damage to the cerebellum, dysfunction of the vestibular analyzer, damage to the spinal cord, the development of polyneuritis, etc.
If it is not possible to detect violations in this way, the study can be modified and complicated, for example, the patient is asked to place his feet one after the other, keeping a straight line.
Flanking gait
When performing this test, the subject moves to the sides, placing one leg next to the other. The eyes remain closed. This study is of great diagnostic value in cases of suspected cerebellar pathologies, since it is often impossible to perform these movements in such clinical cases. Damage to the labyrinth does not make any changes in the flanking gait.
Rotational test
This method's main task is to identify the functional state of the labyrinth, which helps determine the location of the pathological process. The subject sits in a chair with a manual or electric drive and is fixed. The head is slightly tilted forward and down.
After which the doctor sets the chair in motion at a speed of 1 revolution per 2 seconds. After 10 revolutions, it stops abruptly, all deviations of the body, vegetative and other reactions of the patient are recorded. The same actions are performed in the opposite direction, and the obtained indicators are compared.
Caloric test
The basis of the caloric test, as well as the rotational test, is the study of nystagmus, which allows you to assess the functionality of the labyrinth. But in this case, hot or cold water is used as an irritant, which is introduced into the external auditory canal.
Normally, nystagmus appears after 5-10 seconds and lasts 1-2 minutes. One ear is examined first, then the other. The indicators are recorded and compared, and based on the data obtained, overexcitation or, conversely, depression of the labyrinth is diagnosed.
After comparing the results of the last two tests, the doctor sees an objective picture that reveals the degree of irritation of the vestibular apparatus and serves as a fundamental basis for the subsequent differentiation of diseases of the vestibular analyzer.
Romberg test, how are the results assessed?
The results of the Romberg test can be assessed independently. But only a doctor can make an accurate diagnosis, based on the results of several examinations. Here's the simplest interpretation:
- If a person stands calmly and confidently, this is the norm. If there is swaying, it is important to note how long after it began.
- It is also necessary to note in which direction the patient is being “taken” - forward, backward, left or right.
- Does ataxia (that is, staggering) become stronger if the subject closes his eyes.
- Do your eyelids, your toes or hands, or your torso itself tremble?
If a person was able to stand quietly without these symptoms for the allotted time, then we can assume that he does not have functional disorders of the nervous system. Since he passed the Romberg test successfully. If the “alarm bells” described above appear, then this means only one thing - you need to consult a doctor.
Only he will be able to correctly interpret the results from a medical point of view. And determine the order of further important actions.
Children who do not play any sports have different standards for maintaining a calm state. Here are the standards in seconds of the Romberg test for time for children of different ages:
- child 7 years old – 16 seconds;
- children 8 years old – 21 seconds;
- for a child 9 years old – 24 seconds;
- for children 10 years old – 28 seconds;
- children 11 years old – 30 seconds;
- for children 12 years old – 36 seconds;
- children 13 years old – 44 seconds;
- for teenagers 14 years old – 48 seconds;
- teenagers 15 years old – 50 seconds;
- for boys and girls from 16 to 18 years old - from 51 to 53 seconds, respectively.
Instability in the Romberg position
Instability and swaying during execution are the main signs of abnormalities in the functioning of the nervous system.
Moreover, different types of instability indicate different problems:
- an unstable posture with open eyes means problems with the cerebellum;
- staggering both with eyes closed and with open ones speaks of disorders of the cerebral cortex - and the subject falls in the direction opposite to the zone that requires treatment;
- rocking with the patient's eyes closed may be symptoms of diabetes or joint and muscle ailments;
- swinging to the sides are symptoms of neuroses or VSD syndrome (vegetative-vascular dystonia).
I repeat, only an experienced doctor can accurately determine the nature of health deviations! However, at home you can only understand whether there is a reason to contact him or not.
Watch a useful video about how the Romberg pose is not only a diagnostic of the state of the brain and nervous system, but also the vascular system and the spine. In essence, it is the diagnosis of such hidden ailments as arteriosclerosis and cervical osteochondrosis:
So, if staggering or loss of balance is observed in the Romberg pose, then you should definitely do a CT scan of the brain, conduct an ultrasound of the arteries and check the level of cholesterol in the blood.
How testing is carried out
In many ways, balance testing depends on what kind of deviation is being diagnosed. In order for the patient to take the correct position, he needs to stand straight, with his legs pressed tightly against each other.
Next, the patient should stretch his arms in front of him and close his eyes. But test variants are possible when the eyes are closed, but the arms remain in a lowered position along the body. In this situation, the doctor must support the patient, preventing falls and injuries.
If we talk about the sphere of neurological abnormalities, then with this position any staggering is taken into account and the main task of checking the Romberg symptom is to determine the degree of stability. Time intervals are also taken into account, which are also important for correct diagnosis.
A more difficult version of the test involves placing your legs so that they are on the same line. This happens as follows: the patient places his feet so that the heel (for example, the right foot) is in contact with the toes (of the left foot) and they are on the same line.
In this position, the patient should extend his arms in front of him and close his eyes. An option is possible in which the head is thrown back.
Diagnosis of Parry Romberg syndrome in practice: