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RehabMeasures Instrument

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To assess the static balance of clients in a sensory integration taxing condition. 

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Instrument Details

Acronym Tandem Romberg, Modified Romberg

Area of Assessment

Balance – Vestibular
Balance – Non-vestibular

Assessment Type

Performance Measure

Administration Mode

Paper & Pencil




  • Vestibular Disorders

Key Descriptions

  • Subjects are asked to stand, preferably with shoes off, with one foot directly in front of the other foot, heel touching toe.
  • The amount of time (upper limit typically = 30 sec) able to maintain the position is timed, first tested with eyes open, and then eyes closed.
  • Arm position is not standardized, yet typically it is recommended that the client have their arms crossed.

Number of Items


Equipment Required

  • Stopwatch

Time to Administer

2 minutes

Required Training

No Training

Age Ranges


13 - 17



18 - 64


Elderly Adult

65 +


Instrument Reviewers

Elizabeth Dannenbaum MScPT for the Vestibular EDGE task force of the Neurology section of the APTA.

ICF Domain

Body Function

Measurement Domain



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Vestibular Disorders

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Normative Data

El Kashlan et al 1998;

Normative data for right anterior tandem: mean (sd)





Age (years)





Eyes open (sec)

29.5 (2.5)

30.0 (0)

29.0 (4.2)

30 (0.2)

Eyes closed (sec)

26.0 (8.0)

21.3 (9.3)

20.1 (10.8)

16 (9.4)


Vestibular Hypofunction:

Gill-Body et al 2000; Bilateral vestibular hypofunction (= 44) EYES OPEN: mean 13.9/60 sec, SD: 22.83, range 0-60, Unilateral vestibular hypofunction (n = 41) mean 27.06/60 sec, SD 25.51, range 0-60.

Test/Retest Reliability

Franchignoni, et al 1998 Found it to be a good test-retest reliability in healthy woman aged 55-71: test-retest reliability 0.90-0.91, eyes closed 0.76-0.77

Interrater/Intrarater Reliability

Franchignoni et al 1998  Found good interrater reliability in healthy woman aged 55-71: Inter-rater reliability: eyes open 0.99, eyes closed 0.99

Construct Validity

Karapolat et al 2010: In people with unilateral vestibular hypofunction (= 33) there is no correlation between the Modified Romberg test and the Activities-specific Balance Confidence scale (ABC )


El-Kashlan, H. K., Shepard, N. T., et al. (2009). "Evaluation of clinical measures of equilibrium." The Laryngoscope 108(3): 311-319. 

Franchignoni, F., Tesio, L., et al. (1998). "Reliability of four simple, quantitative tests of balance and mobility in healthy elderly females." Aging (Milano) 10(1): 26-31. Find it on PubMed

Gill-Body, K. M., Beninato, M., et al. (2000). "Relationship among balance impairments, functional performance, and disability in people with peripheral vestibular hypofunction." Physical Therapy 80(8): 748-758. 

Karapolat, H., Eyigor, S., et al. (2010). "Reliability, validity, and sensitivity to change of Turkish Activities-specific Balance Confidence Scale in patients with unilateral peripheral vestibular disease." Int J Rehabil Res 33(1): 12-18. Find it on PubMed