Gibbs, Clinton R., Commons, Katherine H., Brown, Lawrence H., and Blake, Denise F. (2010) Sea Legs: sharpened Romberg test after three days on a live-aboard dive boat. Diving and Hyperbaric Medicine, 40 (4). pp. 189-194.

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Abstract

Introduction: The sharpened Romberg test (SRT) is commonly used by diving and hyperbaric physicians as an indicator of neurological decompression illness (DCI). People who spend a prolonged time on a boat a sea experience impairment in their balance on returning to shore, a condition known as mal de debarquement ('sea legs'). This conditioning of the vestibular system to the rocking motion of the boat at sea may impact on the utility of the SRT in assessing a diver with potential DCI after a live-aboard dive trip. Aim: To assess the impact 'sea legs' has on the SRT after three days on a live-aboard dive trip.

Methods: Thirty-nine staff and passengers of a three-day, live-aboard dive trip performed a SRT before and after their journey, with assessment of potential variables, including middle-ear barotrauma, alcohol consumption, sea-sickness and occult DCI.

Results: There was no statistically significant impact on SRT performance, with 100% completion pre-trip and 35 out of 36 divers (97.2%) post-trip. There were trends towards more attempts being required and time needed for successful SRT post-trip, but these were not statistically significant. There was a small, but noteworthy incidence of middle-ear barotrauma, with seven people affected pre-trip, and 13 post-trip. There was a higher incidence in student divers. Middle-ear barotrauma did not appear to have a direct impact on SRT performance.

Conclusions: There was no significant impact on SRT performance resulting from 'sea legs' after three days at sea. Recreational divers, especially dive students, have substantial incidence of middle-ear barotrauma.

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