Romberg Test

By James Parker
/
March 9, 2022

What Is The Romberg test?

The Romberg test is an assessment designed to examine the subject’s sense of balance and motion. The purpose of this diagnostic, non-technical, physical test is to identify a particular impairment in subjects with specific kinesthetic difficulties.

The most common clinical usage of Romberg tests is to examine the sense of balance in individuals who report experiences of imbalance, dizziness, or falls during typical daily activities. This examination is typically performed by a trained expert in neurology or by a licensed physician.

The Romberg test itself is a two-stage examination. The two stages are exactly identical except for one detail: sight. For the first stage, the patient will be asked to remove their shoes and stand with their feet together on a flat, hard surface. Once the subject is in position, the examiner will either ask the subject to cross their arms in front of their body or to place their arms at their sides.

Once the setup has been completed, the test will begin. The examiner will ask the subject to stand still with their eyes open for up to 30 seconds. While the subject is standing this way, the examiner will observe their body movement and balance.

Once the first stage has been completed, the examiner will ask the subject to close their eyes and maintain the position for another 30 seconds. As in the first stage, the examiner will observe the subject and look for any swaying or motions.

There are some variations to the Romberg test that can be used. The sharpened Romberg test has the feet in a different position, with one foot in front of the other touching heel to toe. This version is used to test older individuals or people who are at risk of falling from a neurological disorder. 

The single leg Romberg test is the same as the standard Romberg test with the exception that the individual must stand on one leg. The legs may be alternated for objectivity. Additionally, the examiner may decide that small adjustments must be made in order to more completely examine the subject such as having them stand for 60 seconds at a time.  

Key Takeaways

  • The Romberg test is an examination designed to assess an individual’s sense of balance.
  • Romberg tests are used by neurologists in a clinical setting and a modified version of the Romberg test is used by officers as a roadside sobriety test.
  • While a positive Romberg test can indicate a compromised sense of balance, there are many different physiological conclusions that can be drawn from this result.  
  • If you have been charged with a DUI after failing a Romberg test, an experienced DUI attorney may be able to improve the outcome of your case by leveraging experience and expert testimony.

Romberg test and Driving Under the Influence (DUI) Charges

The Romberg test is not just a neurological test, it is also utilized by police officers during suspected DUI stops. In these instances, some factors like the barefoot testing conditions are usually dropped. Additionally, the officer may not perform a whole Romberg test sometimes having the individual only perform the closed eye portion.

While the officer may be convinced that a defendant failed a Romberg test, their assessment may not have been correct for a variety of reasons. Depending on the terrain near the stop, there may not be a hard, flat surface for the defendant to stand on. Additionally, since the officer is invested in securing the arrest of an individual that they believe is guilty, when they write up the report they do not have any incentive to avoid overly critical interpretations of the Romberg test. 

While neurologists agree that minimal swaying can still count as a negative Romberg test, implying there is no issue, an officer examining someone suspected of driving drunk could see the same negative test conditions and come to the conclusion that the individual was in fact intoxicated. Additionally, intoxication is not the only cause of a positive Romberg test result.

A positive Romberg test denotes an issue with either the sensory system, the balance (vestibular) system, or the kinesthetic motion (proprioceptive) system. In addition to intoxication, there are many other differential diagnoses that could lead to a failed Romberg test. Some examples of other conditions that could lead to a positive “failed” Romberg tests include:

  • Concussion
  • Copper deficiency
  • Extremely elevated zinc levels (Hyperzincemia)
  • Fluid buildup in the brain (Hydrocephalus)
  • Friedreich ataxia
  • Ménière’s disease
  • Metabolic disorders
  • Vertigo
  • Parkinson’s disease
  • Tabes dorsalis
  • Vitamin B12 deficiency
  • Wernicke’s syndrome

These conditions will not only result in enough swaying to cause a positive Romberg test result, in some cases the individual will fall down. To a neurologist looking to examine a patient, this will indicate a problem in need of treatment. To an officer who suspects an individual of being intoxicated, this will indicate a failure justifying arrest and potentially forced blood alcohol content (BAC) testing.

Bottom Line

If you have found yourself charged with a DUI after failing a Romberg test despite having a neurological condition that destabilizes your sense of balance, you will need an experienced DUI attorney to help you secure your rights. Even if you were found to be at or near the legal limit, a test performed after an incorrectly administered roadside sobriety test may be a violation of your rights. 

An expert DUI attorney can produce case law and expert witnesses showcasing how the process of gathering evidence against you was potentially unconstitutional if it was performed under false pretenses. This could lead to charges being dropped and you walking free. Contact a DUI attorney for the best possible outcome for your case.

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