Balance Tests

Question 1

Romberg

Answer 1

Static

Four step progression

1) Eyes open, firm flat surface, no shoes, arms at side, feet together. Pt. stands unsupported for 30 sec. –> LOB, signif sway, use of UE = failed test

2) Eyes closed, same position as above. “Positive romberg” ability to stand in this pos with eyes open but not eyes closed.
- indicative of high reliance on visual system

3) Sharpened romberg; eyes open, tandem stance, stand unsupported for 30 sec

4) sharpened romberg; eyes closed

Not functional, should include additional functional assessments.

Question 2

Single-limb stance test

Answer 2

Static

Functionally informative b/c indicative of stabilization during single-limb support in gait.

Inability to hold for a short period of time indicates high fall risk.

1) Eyes open, firm flat surface, no shoes, arms at side, lift one leg, hold for 30 seconds

2) eyes closed

Question 3

Nudge/push test

Answer 3

Reactive

Eyes open, feet comfortable distance apart, arms at side.

Inform pt. that you will be giving “nudges” in various directions. Goal is to maintain upright position.

Push at front, back, or side. Begin with light force and increase with tolerance. Vary direction, location, timing of nudge.

Assess pt. ability to recover from perturbations. Specific areas or sides more difficult than others?

Question 4

Functional reach test

Answer 4

Anticipatory

Pt. stands next to a wall w/ yardstick. Feet shoulder width apart.

Pt. makes fist and flexes shoulder to 90. Pt. reaches forward without moving feet or touching wall.

Head of 3rd metacarpal corresponds to distance on yardstick.

Can also be done in lateral direction.

Question 5

Catching

Answer 5

Anticipatory

5-10 ft away from pt.

Progressively vary trajectory of ball (high/low, left/right, outside of BOS)

Vary speed of toss. Introduce challenge by having pt. stand on unstable surface.

Question 6

Dynamic balance assessments

Answer 6

Berg balance scale
Tinetti (POMA)
mini-BEST
TUG