Anagnostou Evangelos, Gamvroula Anastasia, Kouvli Maria, Karagianni Evangelia, Stranjalis George, Skoularidou Maria, Kalamatianos Theodosis
Department of Neurology, University of Athens, Eginition Hospital, 11528 Athens, Greece.
Department of Neurosurgery, National and Kapodistrian University of Athens, Evangelismos Hospital, 10676 Athens, Greece.
Diagnostics (Basel). 2025 Jun 26;15(13):1621. doi: 10.3390/diagnostics15131621.
: The vestibular Romberg test, which assesses the deterioration of balance while standing on rubber foam with closed eyes, is a well-established method in the physical neurological assessment of patients with peripheral vestibulopathy. This study aims to determine whether it can differentiate peripheral vestibulopathy from its main differential diagnosis, namely sensory ataxia, as both conditions typically present with a positive classical Romberg test. : Static balance was assessed in three groups: patients with peripheral vestibulopathy, patients with pure sensory neuropathy, and healthy age-matched controls. Participants stood quietly on a force platform under varying visual and proprioceptive feedback conditions. Conventional and advanced postural sway metrics were investigated to establish a quantitative analogy to both the clinical Romberg and vestibular Romberg tests. : Posturographic analysis revealed that, in contrast to healthy controls, patients with vestibular disorders exhibited higher vestibular Romberg quotient values. However, the classical vestibular Romberg quotient did not show diagnostic discrimination between vestibulopathy and sensory neuropathy patients. This lack of discrimination was mainly due to the increased body sway observed in all patient groups under the "eyes open" condition. Nevertheless, a refined vestibular Romberg quotient-comparing standing on foam versus standing on firm support with eyes closed-was able to reliably distinguish vestibulopathy from sensory ataxia. This distinction was evident in both conventional linear sway and spectral postural sway metrics. : We conclude that a refined Romberg test, performed solely under conditions of visual deprivation, offers valuable classification potential in differentiating peripheral vestibulopathy not only from healthy controls but also from patients with disequilibrium due to sensory loss.
前庭罗姆伯格试验是一种在对患有外周前庭病变的患者进行物理神经学评估时已确立的方法，该试验通过让患者闭眼站在橡胶泡沫上评估平衡能力的下降情况。本研究旨在确定它是否能够将外周前庭病变与其主要鉴别诊断，即感觉性共济失调区分开来，因为这两种情况通常都会出现经典罗姆伯格试验阳性。
外周前庭病变患者、单纯感觉性神经病变患者以及年龄匹配的健康对照者。参与者在不同的视觉和本体感觉反馈条件下安静地站在测力平台上。研究了传统和先进的姿势摆动指标，以建立与临床罗姆伯格试验和前庭罗姆伯格试验的定量类比。
姿势描记分析显示，与健康对照者相比，前庭障碍患者的前庭罗姆伯格商值更高。然而，经典的前庭罗姆伯格商在区分前庭病变患者和感觉神经病变患者时并未显示出诊断差异。这种缺乏区分主要是由于在“睁眼”条件下所有患者组中观察到的身体摆动增加。尽管如此，一种经过改进的前庭罗姆伯格商——比较闭眼站在泡沫上与站在坚实支撑物上的情况——能够可靠地将前庭病变与感觉性共济失调区分开来。这种区分在传统的线性摆动和频谱姿势摆动指标中都很明显。
我们得出结论，仅在视觉剥夺条件下进行的改进罗姆伯格试验，在区分外周前庭病变不仅与健康对照者，而且与因感觉丧失导致平衡失调的患者方面具有有价值的分类潜力。
