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Sharpening the Sharpened Romberg
1Department of Diving and Hyperbaric Medicine, Lumut Armed Forces Hospital, Malaysia. ctlee@tm.net.my
SPUMS Journal
|September 7, 2001
Summary
The Sharpened Romberg Test (SRT) shows a learning effect in early attempts but is not impacted by diving fatigue or decompression. Abnormal SRT scores may indicate decompression illness (DCI) in divers.
Area of Science:
- Diving Medicine
- Neurology
- Physiology
Background:
- The Sharpened Romberg Test (SRT) assesses balance, crucial in diving medicine.
- Interpreting abnormal SRT results can be challenging due to confounding factors.
- This study aimed to clarify the SRT's utility in evaluating divers.
Purpose of the Study:
- To evaluate the practice effect on SRT performance.
- To assess the impact of post-dive factors (decompression, fatigue, motion sickness) on SRT.
- To compare SRT scores in healthy individuals versus those with decompression illness (DCI).
Main Methods:
- Volunteers (naval and civilian) performed SRT in morning and evening trials.
- Divers' SRT scores were measured immediately before and after dives.
- SRT score distributions were compared between control subjects and a retrospective DCI patient group.
Main Results:
- A significant learning effect was observed between the first and second SRT attempts within a trial (p<0.001).
- Post-dive SRT scores showed a decline in the first attempt only (p<0.05), with no significant impact from decompression or fatigue.
- DCI patients exhibited a bimodal SRT score distribution, with 46% scoring below 40 seconds, compared to 5% of controls.
Conclusions:
- The SRT demonstrates an initial learning effect that plateaus quickly.
- The SRT is robust against common post-dive physiological effects like fatigue and decompression.
- An SRT cutoff of <40 seconds offers 46% sensitivity and 95% specificity for identifying DCI.