The modified Romberg test using a foam pad (“MRuFP”) as a bedside examination has been used to assess the function of the complex sensory input needed for upright stance. The objective of this study was to assess its clinical value detecting vestibular falls in comparison with the sensory organization test (SOT), the gold standard. In total, 80 patients who had undergone the MRuFP, SOT, and bithermal caloric tests were included in this study. The MRuFPs were performed on two (height 12 cm, MRu2FP) or three (18 cm, MRu3FP) layers of foam pads. The odds ratios of falling on SOT were calculated. Iterative algorithms were used for linear curve fitting between the balance time on the MRuFP and SOT equilibrium score (ES). The diagnostic performance of MRuFP under different conditions was poor, with low sensitivity (0.07–0.63), when the results of SOT were used as the gold standard. However, the odds ratios of failing SOT condition 5 were 6.78 (95 % CI = 1.26–36.50) for patients with abnormal findings on eyes closed (EC)–MRu2FP and 10.91 (95 % CI = 2.58–46.11) for those on the EC–MRu3FP in patients without caloric weakness. In patients with caloric weakness, the odds ratio of failing SOT condition 5 for patients with abnormal findings on EC–MRu2FP was 7.0 (95 % CI = 0.69–70.74, p > 0.05), and 32.0 for those on EC-MRu3FP (95 % CI = 2.81–364.7). A linear equation was presented as the model fit (adjusted R2 = 0.355) predicting the SOT condition 5 ES according to the balance time on EC–MRu3FP. In conclusion, the EC–MRu3FP, as a bedside examination, correlated well with SOT condition 5 as an objective measure.
Romberg test Screening Posture Vertigo
This study was partly supported by Seoul National University Bundang Hospital Research Fund (Grant No. 03-2011-007).
Conflict of interest
We certify that there is no conflict of interest with any financial organization regarding the material discussed in the manuscript.
Nieschalk M, Delank KW, Stoll W (1995) Quantitative evaluation of the Romberg test. Laryngorhinootologie 74:489–494CrossRefPubMedGoogle Scholar
Soto A, Labella T, Santos S, Rio MD, Lirola A, Cabanas E et al (2004) The usefulness of computerized dynamic posturography for the study of equilibrium in patients with Meniere’s disease: correlation with clinical and audiologic data. Hear Res 196:26–32CrossRefPubMedGoogle Scholar
Stewart MG, Chen AY, Wyatt JR, Favrot S, Beinart S, Coker NJ et al (1999) Cost-effectiveness of the diagnostic evaluation of vertigo. Laryngoscope 109:600–605CrossRefPubMedGoogle Scholar
Koo JW, Kim JS, Hong SK (2011) Vibration-induced nystagmus after acute peripheral vestibular loss: comparative study with other vestibule-ocular reflex tests in the yaw plane. Otol Neurotol 32:466–471CrossRefPubMedGoogle Scholar
Di Berardino F, Filipponi E, Barozzi S, Giordano G, Alpini D, Cesarani A (2009) The use of rubber foam pads and “sensory ratios” to reduce variability in static posturography assessment. Gait Posture 29:158–160CrossRefPubMedGoogle Scholar
Fujimoto C, Murofushi T, Chihara Y, Ushio M, Sugasawa K, Yamaguchi T et al (2009) Assessment of diagnostic accuracy of foam posturography for peripheral vestibular disorders: analysis of parameters related to visual and somatosensory dependence. Clin Neurophysiol 120:1408–1414CrossRefPubMedGoogle Scholar
Ortuno-Cortes MA, Martin-Sanz E, Barona-de Guzman R (2008) Static posturography versus clinical tests in elderly people with vestibular pathology. Acta Otorrinolaringol Esp 59:334–340CrossRefPubMedGoogle Scholar
Baloh RW, Jacobson KM, Beykirch K, Honrubia V (1998) Static and dynamic posturography in patients with vestibular and cerebellar lesions. Arch Neurol 55:649–654CrossRefPubMedGoogle Scholar
Black FO, Wall C 3rd (1981) Comparison of vestibulo-ocular and vestibulospinal screening tests. Otolaryngol Head Neck Surg 89:811–817PubMedGoogle Scholar
Evans MK, Krebs DE (1999) Posturography does not test vestibulospinal function. Otolaryngol Head Neck Surg 120:164–173CrossRefPubMedGoogle Scholar
Kong WJ, Liu B, Wu Q, Wu YY (2007) Postural characteristics of healthy subjects under different thickness of foam. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 42:721–725PubMedGoogle Scholar
Patel M, Fransson PA, Lush D, Gomez S (2008) The effect of foam surface properties on postural stability assessment while standing. Gait Posture 28:649–656CrossRefPubMedGoogle Scholar
Telian SA, Shepard NT, Smith-Wheelock M, Hoberg M (1991) Bilateral vestibular paresis: diagnosis and treatment. Otolaryngol Head Neck Surg 104:67–71PubMedGoogle Scholar
Turano K, Herdman SJ, Dagnelie G (1993) Visual stabilization of posture in retinitis pigmentosa and in artificially restricted visual fields. Invest Ophthalmol Vis Sci 34:3004–3010PubMedGoogle Scholar
Jacobson GP, McCaslin DL, Piker EG, Gruenwald J, Grantham S, Tegel L (2011) Insensitivity of the “Romberg test of standing balance on firm and compliant support surfaces” to the results of caloric and VEMP tests. Ear Hear 32:e1–e5CrossRefPubMedGoogle Scholar
Hamid MA, Hughes GB, Kinney SE (1991) Specificity and sensitivity of dynamic posturography. A retrospective analysis. Acta Otolaryngol Suppl 481:596–600CrossRefPubMedGoogle Scholar
Goto F, Kabeya M, Kushiro K, Ttsutsumi T, Hayashi K (2011) Effect of anxiety on antero-posterior postural stability in patients with dizziness. Neurosci Lett 487:204–206CrossRefPubMedGoogle Scholar
Celebisoy N, Bayam E, Gulec F, Kose T, Akyurekli O (2009) Balance in posterior and horizontal canal type benign paroxysmal positional vertigo before and after canalith repositioning maneuvers. Gait Posture 29:520–523CrossRefPubMedGoogle Scholar