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Related Experiment Video

Updated: May 7, 2026

Screening People on Standing Balance with Romberg Testing and Walking Balance with Tandem Walking

Screening People on Standing Balance with Romberg Testing and Walking Balance with Tandem Walking

Published on: September 1, 2023

Sharpening the tandem walking test for screening peripheral neuropathy.

Helen S Cohen¹, Ajitkumar P Mulavara, Brian T Peters

¹From the Bobby R. Alford Department of Otolaryngology-Head and Neck Surgery, the Department of Obstetrics and Gynecology, and the Department of Neurology, Baylor College of Medicine, the Universities Space Research Association, the Wyle Science, Technology and Engineering Group, and the Neuroscience Research Laboratories, NASA/Johnson Space Center, Houston, Texas.

Southern Medical Journal

|October 8, 2013

Summary

The tandem walking (TW) test, especially with eyes closed, can help screen for peripheral neuropathy (PN). Counting steps during TW is a useful, quick clinical tool for identifying potential PN cases.

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Area of Science:

Neurology
Biomedical Engineering
Clinical Assessment

Background:

Screening for lower extremity peripheral neuropathy (PN) often lacks rapid, functional motor behavior tests.
The widely used tandem walking (TW) test is a potential candidate for improvement in PN screening.

Purpose of the Study:

To enhance the utility of the tandem walking (TW) test for the rapid screening of peripheral neuropathy (PN).

Main Methods:

Adults, including healthy controls and ambulatory patients with PN, performed TW with eyes open and closed on carpeting.
Kinematic data were collected using a torso-mounted inertial motion unit.
PN data were compared with historical data from patients with vestibular impairments.

Main Results:

Significant differences were observed between normal and PN groups in TW performance and step count.
Patients with PN exhibited greater instability compared to controls based on kinematic data.
The number of steps during eyes-closed TW yielded higher receiver operating characteristic (ROC) values (0.88) compared to eyes-open (0.81).

Conclusions:

Counting steps during TW is a valuable and rapid clinical test for screening potential PN, though not ideal.
Testing with eyes closed enhances the sensitivity of the TW test for detecting PN.