Modified Romberg Test & Example | Free PDF Download (2024)

Templates

Modified Romberg Test

Medical
Medical Practitioner
General Practitioner
Physical Therapy
Physical Therapist
Nurse
Nursing
Nurse Educator

Learn how the Modified Romberg Test helps diagnose lumbar spine stenosis and balance issues. Download our template for a comprehensive assessment and accurate results.

Modified Romberg Test & Example | Free PDF Download (1)

By Telita Montales on Jun 18, 2024.

Modified Romberg Test & Example | Free PDF Download (2)

Fact Checked by Ericka Pingol.

Use Template

Modified Romberg Test & Example | Free PDF Download (3)

Get this now

Use Template

Table of content

What is lumbar spine stenosis?What is the Modified Romberg Test?How to interpret the resultsModified Romberg Test exampleBenefits of conducting this testWhy use Carepatron as your physical therapy software?FAQs

Share

What is lumbar spine stenosis?

Lumbar spine stenosis refers to the narrowing of the spinal canal in the lower back. This condition can compress the nerves and spinal cord and cause pain, numbness, or weakness. It often results from age-related changes in the spine, such as arthritis, herniated discs, or thickened ligaments.

Symptoms of lumbar spine stenosis

These are the symptoms of lumbar spine stenosis:

  • Pain or cramping in the lower back or legs
  • Numbness or tingling in the legs or feet
  • Muscle weakness that affects mobility
  • Reduced endurance for walking or standing

Causes of lumbar spine stenosis

Here are the causes of lumbar spine stenosis:

  • Age-related degeneration leading to bone overgrowth
  • Herniated discs pressing on nerves
  • Thickening of spinal ligaments
  • Congenital spinal deformities

Printable Modified Romberg Test

Download this Modified Romberg Test guide to accurately assess balance and neurological function in your patients.

Download PDF TemplateDownload Example PDF

What is the Modified Romberg Test?

The Modified Romberg Test is a balanced assessment that helps detect vestibular and proprioceptive disorders by assessing the patient's ability to maintain balance under different conditions.

While the traditional Romberg Test uses a simple stance with feet together, the modified version tests balance by having the patient stand with one foot directly in front of the other (tandem stance), further challenging the vestibular system.

How is this conducted?

The Modified Romberg Test helps healthcare professionals better evaluate the integrity of the vestibular system, proprioception, and the neurological pathways responsible for maintaining balance.

The Modified Romberg Test provides a comprehensive sensory and vestibular function evaluation by assessing the patient’s ability to maintain balance with both eyes open and closed.

Initial setup

  • Positioning: Have the patient stand in a tandem stance, with one foot placed directly in front of the other (heel to toe). This setup places additional demand on the vestibular system, making it easier to detect subtle balance issues.
  • Safety precautions: Ensure the patient is in a safe environment, preferably close to a wall or stable structure they can hold onto if needed. A healthcare provider should stand nearby to offer support if the balance is lost.

Conducting the test

  • Eyes open stage: Instruct the patient to keep their arms relaxed by their sides and to maintain balance in the tandem stance with their eyes open for 30 seconds. This stage assesses the patient’s ability to maintain balance using all available visual, proprioceptive, and vestibular cues.
  • Eyes closed stage: Have the patient close their eyes while maintaining the tandem stance for another 30 seconds. The absence of visual input increases the reliance on the proprioceptive and vestibular systems for balance, making this stage a more challenging assessment.

Monitor for indicators

  • Observe the patient for significant swaying, loss of balance, or an inability to hold the stance.
  • A positive Romberg Test may include symptoms like swaying, frequent use of external support, or a stepping response to catch balance. These signs may indicate potential sensory pathway impairment or issues with the vestibular system that need further evaluation.

By following these steps, clinicians can effectively conduct the Modified Romberg Test to identify possible balance impairments, providing crucial information to guide further neurological assessments and treatment.

How to interpret the results

The Modified Romberg Test provides essential information to guide diagnosis and treatment, helping healthcare professionals create targeted intervention plans for patients experiencing balance-related concerns.

Positive test

A positive result indicates that the patient cannot maintain balance during the test, particularly with their eyes closed, or exhibits significant swaying, stepping to stabilize, or a complete loss of balance. Such findings suggest a potential sensory or vestibular dysfunction. It indicates issues with proprioception, the vestibular system, or the sensory pathways responsible for maintaining balance. This result warrants further investigation to identify the underlying cause and may point toward conditions like vestibular disorders, sensory neuropathy, or other neurological issues.

Negative test

A negative result signifies that the patient can maintain balance without significant swaying or needing external support. They should be able to hold the tandem stance for 30 seconds with their eyes closed and open, demonstrating stable balance and intact vestibular function. This outcome indicates a normal response to the physical test, suggesting no significant abnormalities in the sensory, vestibular, or proprioceptive systems that control balance.

By differentiating between positive and negative results in the Modified Romberg Test, clinicians can gain valuable insights into a patient's neurological and sensory health, guiding further assessment or treatment planning.

Modified Romberg Test example

By requiring the patient to stand in a tandem stance (heel-to-toe) rather than feet together, the Modified Romberg balance test is better suited for identifying subtle impairments in sensory or vestibular function.

For instance, during an assessment, the patient stands with one foot directly in front of the other and maintains balance for 30 seconds with eyes open and another 30 seconds with eyes closed. The healthcare provider carefully observes the patient for significant swaying, stepping, or instability during the test, which may indicate sensory or vestibular dysfunction. This thorough evaluation can reveal conditions like vestibular disorders, sensory neuropathy, or lumbar spine stenosis.

Download our free Modified Romberg Test template example here

Benefits of conducting this test

Conducting the free Modified Romberg Test offers several key advantages in assessing and diagnosing balance disorders:

Comprehensive vestibular and proprioceptive assessment

The test effectively evaluates the visual and vestibular components and proprioceptive systems by requiring the patient to maintain balance in a tandem stance, both with eyes open and closed. This reveals deficits in balance crucial for identifying underlying conditions affecting sensory or vestibular function.

Differentiates between visual and non-visual balance components

By performing the test with the patient's eyes open and then closed, clinicians can determine how much the patient relies on visual cues to maintain balance. The eyes-closed stage eliminates visual compensation, uncovering non-visual balance impairments related to the vestibular system or proprioception.

Identifies neurological conditions affecting balance

The test is particularly effective in identifying signs of neurological conditions such as vestibular disorders, sensory neuropathy, and lumbar spine stenosis. A positive Romberg Test, where the patient loses balance or exhibits significant swaying, suggests vestibular dysfunction or issues with proprioceptive sensory pathways.

Facilitates accurate diagnosis and treatment planning

The test provides detailed insights that support the diagnosis of balance impairments and guide treatment plans. Clinicians can tailor their interventions to address the specific sensory or vestibular deficits impacting the patient’s balance.

Overall, the Modified Romberg Test is a valuable tool for healthcare professionals conducting balance assessments, enabling a more accurate and nuanced understanding of balance impairments and their underlying causes.

Is lumbar spine stenosis treatable without surgery?

Is lumbar spine stenosis treatable without surgery?

Commonly asked questions

Is lumbar spine stenosis treatable without surgery?

Modified Romberg Test & Example | Free PDF Download (5)

Treatments like physical therapy, pain management, and lifestyle changes can significantly alleviate symptoms.

How does the Modified Romberg Test help with lumbar spine stenosis diagnosis?

Modified Romberg Test & Example | Free PDF Download (6)

It can detect vestibular and proprioceptive issues, which are common symptoms of this condition.

How long does it take to recover from lumbar spine stenosis?

Modified Romberg Test & Example | Free PDF Download (7)

The recovery time depends on the severity of the condition and the type of treatment pursued. Non-surgical treatments like physical therapy may improve within a few weeks to several months. However, if surgery is necessary, recovery can take up to six months or longer, depending on the procedure.

Modified Romberg Test & Example | Free PDF Download (8)

Modified Romberg Test & Example | Free PDF Download (9)

Modified Romberg Test & Example | Free PDF Download (10)

No items found.

Popular Templates

OB GYN Coding Cheat Sheets PDF

Download Carepatron's free PDF guide with OB GYN coding cheat sheets and examples to help you accurately code for obstetrics and gynecology procedures.

Personal Attributes Questionnaire

Learn what a Personal Attributes Questionnaire (PAQ) is and access Carepatron's free PDF download of an example. Understand how this tool can help you assess personal attributes effectively.

Pittsburgh Knee Rule

Read about the Pittsburgh Knee Rules, a clinical decision rule tool for managing acute knee injuries. Learn about their application and reliability.

Knowledge Deficit Nursing Care Plan

Explore our comprehensive Knowledge Deficit Nursing Care Plans guide, which includes free templates and examples to enhance patient education and care.

Achilles Tendon Tear Treatment Guidelines Handout

Here is a free Achilles Tendon Tear Treatment Guidelines Handout to support your patients' treatment. Download today!

Subscapularis Anatomy Diagram

What is the subscapularis muscle? How does it function as part of the rotator cuff muscles? Download our free anatomy diagram to gain a detailed understanding of this crucial muscle.

Cuboid Syndrome Treatment Guidelines Handout

Use our Cuboid Syndrome Treatment Guidelines Handout to help manage Cuboid Syndrome and support your patients' recovery. Download the template and example now!

Culturagram Template

Explore how our Culturagram Template can enhance your understanding of culturally diverse families. Ideal for social workers and healthcare providers, this tool gathers crucial cultural insights to inform more personalized care.

Bernese Ankle Rules

Discover how to use the Bernese Ankle Rules for effective ankle injury assessment. Learn the benefits, step-by-step procedures, and treatments for accurate diagnosis and care.

Lhermitte Sign Test

Identify the shock sensation in the spine triggered by neck flexion, often indicating MS, with the Lhermitte Sign Test. Explore diagnosis and treatment.

Syringomyelia Treatment Guidelines

Discover comprehensive syringomyelia treatment guidelines for healthcare professionals. Learn about diagnosis, treatment options, and management.

Ankle Dorsiflexion Test

Learn about ankle dorsiflexion testing with our guide and free template. Discover techniques, benefits, and treatment options for improved ankle mobility.

Cervical Spondylosis Treatment Guidelines Handout

Download Carepatron's free PDF handout featuring guidelines and examples for the treatment of cervical spondylosis. Learn more about effective treatment options for this condition.

Bent Knee Stretch Test

Discover the Bent Knee Stretch Test with our detailed guide and template. Learn how to assess and manage proximal hamstring tendinopathy effectively.

Habit 1: Be Proactive Worksheet

Improve control and focus with our Habit 1: Be Proactive Worksheet designed to help clients become highly effective people. Download for free.

Cooper 12 Minute Run Test

Read our guide to learn about the Cooper 12-Minute Run Test, which assesses aerobic fitness. Get our free template for accurate testing and tracking results.

Rapid Entire Body Assessment

Discover the Rapid Entire Body Assessment & example on our website! Get Carepatron's free PDF and learn more about this body assessment method.

Melanoma Treatment Guidelines Handout

Download Carepatron's free PDF handout and example on melanoma treatment guidelines to better understand the recommended treatment options for melanoma.

Psoas Anatomy Diagram

Get access to a free Psoas Anatomy Diagram. Download the PDF and use as a handy reference for your practice.

Meniere's Disease Treatment Guidelines

Learn about effective treatment guidelines for Meniere's Disease, including example regimens and tips for managing symptoms, all available in Carepatron's free PDF download.

Closed Chain Exercises Handout

Enhance your physical therapy practice with our comprehensive Closed Chain Exercises Handout. Learn the benefits, get sample exercises, and see why Carepatron is essential!

MRC Scale for Muscle Strength

Enhance patient care with our guide on regular muscle strength testing using the MRC scale. Diagnose and monitor neuromuscular conditions effectively!

Hemorrhagic Shock Classification Table

Discover our comprehensive guide and free template on Hemorrhagic Shock Classification. Learn about the signs, causes, and treatments of hemorrhagic shock.

Adjacent Segment Disease Treatment Guidelines

Comprehensive Adjacent Segment Disease Treatment Guidelines for healthcare professionals. Download our free PDF example for detailed management strategies.

Exercises for Gluteal Tendinopathy Handout

Download Carepatron's free PDF handout of Exercises for Gluteal Tendinopathy, along with examples to help alleviate pain and improve strength and mobility in the hips and buttocks.

Critical Care Time Chart

Ensure accurate billing and documentation with our comprehensive guide on critical care time. Learn the benefits, FAQs, and why Carepatron is the best software.

Osgood-Schlatter Disease Treatment Guidelines

Learn the benefits of having Osgood-Schlatter Disease Treatment Guidelines on hand by downloading our free template today!

Supine Roll Test

Learn how to conduct and interpret the Supine Roll Test for diagnosing HC-BPPV. Download our template with sample answers and improve patient care today!

Olecranon Fracture Classification Table

Explore the major classification systems for olecranon fractures—Mayo, Schatzker, and AO/OTA—to understand how these guide treatment strategies and predict outcomes in elbow injuries.

Pelvic Floor Dysfunction Exercises Handout

Download our Pelvic Floor Dysfunction Exercises Handout and use this handy resource to help a patient treat Pelvic Floor Dysfunction.

Neck Flexor Endurance Test

Learn about the Neck Flexor Endurance Test, including how it is conducted and what it measures. Download Carepatron's free PDF example to see how this test is performed.

Quadriceps Active Test

Streamline your physical therapy practice with our Quadriceps Active Test template. Improve accuracy, efficiency, and patient outcomes with Carepatron's comprehensive software.

Erb's Palsy Treatment Guidelines Handout

Learn essential information about Erb's palsy by downloading our Erb's Palsy Treatment Guidelines Handout. Use this handout to educate and support your patients.

Horner's Syndrome Diagnosis Guidelines Handout

Download our free Horner's Syndrome Diagnosis Guidelines Handout to provide clients with a handy tool for understanding Horner's Syndrome.

Lateral Scapular Slide Test

Discover the benefits and steps of the Lateral Scapular Slide Test. Learn how to assess shoulder stability and improve patient outcomes with our free template.

Body Composition Test

Discover essential Body Composition Tests and techniques to enhance patient care. Download our free template for accurate assessments and improved health outcomes.

Medicine Ball Throw Test

Discover the Medicine Ball Throw Test for evaluating strength and power. Learn about the test and how to interpret results with our guide and template.

Phelps Test

Discover the Phelps Test for assessing gracilis muscle contractures. Use our template for accurate diagnosis and effective treatment planning.

Salt Test

Explore the Salt Test for pregnancy with our comprehensive guide and free template. Learn about its use, benefits, and why it's popular for early testing at home.

Schatzker Classification Worksheet

Explore the Schatzker Classification system to effectively categorize and manage tibial plateau fractures, enhancing treatment accuracy.

Wrist Radiograph for Carpal Bone Fractures Worksheet

Explore our detailed Wrist Radiograph for Carpal Bone Fractures Worksheet for insights into effectively diagnosing and treating wrist fractures.

Danis Weber Classification

Explore the Danis Weber Classification system for ankle fractures. Understand lateral ankle fracture types, symptoms, causes, and treatments. Download our free PDF template.

Dental Radiograph Chart

Discover how to use dental radiograph charts effectively in your practice. Download our free example and learn about the types, safety, and benefits of dental x-rays.

HPI Template

Download our comprehensive HPI Template to streamline and improve the collection of a patient's history of present illness (HPI), which is essential for accurate diagnosis and treatment planning.

Lauge-Hansen Classification

Explore the Lauge-Hansen Classification for ankle fractures. Download a free PDF example of using this essential tool in orthopedic surgery for better diagnosis and treatment planning.

Mckenzie Method Exercises

Discover how McKenzie Method Exercises can provide significant pain relief for back and neck issues. Explore exercises for maximizing effectiveness with our comprehensive guide.

Osteomyelitis Classification Table

Get Carepatron's free PDF download of an Osteomyelitis Classification Table along with examples for easy reference and understanding of this medical condition.

24-hour Caregiver Schedule Template

Download Carfepatron's free PDF template and example for a 24-hour caregiver schedule. Stay organized and ensure proper care.

Ethical Principles in Healthcare

Learn about key Ethical Principles in Healthcare with Carepatron's free PDF download. Explore examples and best practices to ensure ethical decision-making in the healthcare industry.

Heel Thump Test

Learn how the Heel Thump Test helps diagnose syndesmosis injuries, including its procedure, benefits, and limitations, with our detailed guide and template.

Pelvic Binding Treatment Plan

Learn about Pelvic Binding treatment plans and download Carepatron's free PDF example to help you understand the process and treatment options available.

Gait Training Exercises Handout

Learn about effective gait training exercises with Carepatron's free PDF download handout and example. Improve your walking ability with these exercises.

DN4 Questionnaire

Learn about the DN4 Questionnaire, its purpose, and how to use it with Carepatron's free PDF download. Get an example questionnaire to guide you in assessing neuropathic pain.

Nursing Interventions for Respiratory Distress Handout

Discover essential nursing interventions for managing respiratory distress with a helpful example PDF download from Carepatron. Level up your skills now!

Necrotizing Fasciitis Diagnosis Guidelines Handout

Learn all about necrotizing fasciitis diagnosis with our comprehensive guidelines handout and example. Get Carepatron's free PDF download now!

Elbow Dislocation Treatment Guidelines Handout

Download our Elbow Dislocation Treatment Guidelines Handout to empower patients in their recovery journey and give them information about treating elbow dislocations.

Garden Classification of Femoral Neck Fractures PDF

Explore the Garden Classification for femoral neck fractures: a key guide for diagnosing severity, guiding treatment, and predicting outcomes.

Good Faith Exam

Learn about good faith and get examples of good faith exams. Download a free PDF to understand how this principle applies in various situations.

Injury Severity Score Worksheet

Explore the use of the Injury Severity Score (ISS) Worksheet for assessing trauma severity in patients.

Breastfeeding Care Plan Chart

Learn how a Breastfeeding Care Plan Chart helps mothers and babies with structured guidance, addressing challenges, and promoting successful breastfeeding.

Ankle Radiograph Results Template

Explore our Ankle Radiograph Results Template for detailed, structured radiographic reporting and accurate diagnosis of ankle conditions.

Sacroiliac Compression Test

Learn how to perform the Sacroiliac Compression Test with our comprehensive guide and template, ideal for diagnosing sacroiliac joint issues effectively.

Ethical Principles in Nursing

Download Carepatron's free PDF handout on Ethical Principles in Nursing, along with examples to help nurses navigate moral dilemmas in healthcare settings.

Gunshot Wound Treatment Guidelines Handout

Access Carepatron's free PDF download of gunshot wound treatment guidelines handout. Learn how to treat gunshot wounds and save lives properly.

Maudsley's Test

Defeat tennis elbow with precision using Maudsley’s Test. Overcome lateral epicondylitis and regain mobility!

Rapid Upper Limb Assessment

Learn about Rapid Upper Limb Assessment with examples on our site. Get Carepatron's free PDF download today!

Therapist Bio Template

Keep a comprehensive Therapist Bio with our template and example, tailored to help you connect with potential clients.

Cluster of Laslett

Sacroiliac joint pain can be effectively managed when assessed with Cluster of Laslett's tests. Learn the diagnostic and treatment strategies.

Lever Sign Test

Discover the Lever Sign Test for ACL injury assessment. Learn how to conduct the test and interpret results with our comprehensive guide and free template.

2-2-3 Custody Schedule Template

Create a personalized parenting plan with our 2-2-3 Custody Schedule Template. Download one here for free!

Motor Assessment Scale

Carepatron's Motor Assessment Scale free PDF download provides a comprehensive understanding of motor assessment and give accurate diagnosis.

Gait Cycle Chart

Discover the importance of the Gait Cycle Chart, its phases, and how healthcare professionals can use our comprehensive template for effective gait analysis.

Knee Radiograph Results Template

Discover our comprehensive knee radiograph results template for diagnosing and managing knee conditions.

Foot Radiograph

Explore the various uses of foot radiographs, learn how to interpret them, and download our free example of a Foot Radiograph chart

Klumpke Palsy Treatment Guidelines Handout

Get the complete Klumpke Palsy Treatment Guidelines Handout & Example for free! Download Carepatron's PDF now and learn more about this condition and its treatment options.

Hawkins Classification Chart

Access to a free Hawkins Classification Chart and an example for your physical therapy practice. Learn how to use the chart to classify talar neck fractures.

Rent Test

Explore effective treatments for rotator cuff tears, learn about the Rent Test, and download our free template for precise assessments.

Kim Test

Explore the clinical insights and expertise on the Kim Test, an essential reading for medical practitioners seeking to enhance patient care.

Pediatric Sleep Questionnaire

Carepatron offers a free PDF download of a Pediatric Sleep Questionnaire example. Learn more about pediatric sleep patterns and behaviors through this guide.

Pneumothorax Nursing Care Plan

Discover essential information on creating nursing care plans for pneumothorax. Download Carepatron's free PDF example for reference.

Passive Compression Test

Get Carepatron's free PDF download on passive compression test with examples to enhance your understanding. Start learning now!

Cotton Test

Download Carepatron's free Cotton Test PDF template and get hands-on with cotton testing and examples.

Hypoglycemia Nursing Care Plan

Learn how to manage hypoglycemia effectively with Carepatron's comprehensive nursing care plan. Download a free PDF example today!

Anaphylaxis Nursing Care Plan

Explore effective anaphylaxis management strategies, symptoms, causes, and essential nursing interventions in our detailed guide.

Kohlberg Chart

Explore Kohlberg's theory of moral development through our detailed Kohlberg Chart. Understand the stages and download our free Kohlberg Chart template.

7 Areas of Life Goals Worksheet

Download our 7 Areas of Life Goal Worksheet template to effectively help clients set and track their personal and professional goals across key life areas.

List of Commonly Used Modifiers in Medical Billing PDF

Unlock precision in medical billing! Download our free List of Modifiers in Medical Billing PDF for accurate coding and improved reimbursem*nts. Get it now!

Pain Management Guidelines (CDC Guideline for Prescribing Opioids for Chronic Pain)

Discover evidence-based Pain Management Guidelines designed to enhance patient care. Learn strategies for effectively diagnosing, treating, and managing acute and chronic pain.

Antibiotic Chart

Explore our Antibiotic Chart for effective treatment decisions and resistance management.

Fluid and Electrolyte Imbalance Nursing Care Plan

Learn about fluid intake, electrolyte balance, blood pressure, and nursing interventions for fluid and electrolyte imbalances. Download the free PDF now!

Ottawa Knee Rules

Our free template and comprehensive guide will help you discover how the Ottawa Knee Rules can help assess acute knee injuries, reduce unnecessary radiographs, and guide treatment.

Respiratory Failure Nursing Care Plan

Elevate your patient care skills and learn to create effective care for respiratory failure with Carepatron's Respiratory Failure Nursing Care Plan template.

Anxiety Nursing Diagnosis

Understand how nurses assess and manage anxiety, including patient interviews, observation, and the use of specialized tools in this comprehensive guide.

Chronic Kidney Disease Nursing Care Plan

Get comprehensive guidance on diagnosing and managing CKD. Download the Chronic Kidney Disease Nursing Care Plan for personalized patient support.

Adductor Squeeze Test

Explore the Adductor Squeeze Test with our detailed guide. Assess adductor muscle strength effectively and discover the benefits of using our template.

Rivermead Mobility Index

Explore the Rivermead Mobility Index with our comprehensive guide and template, designed to improve mobility assessment accuracy in clinical settings.

Moving Valgus Stress Test

Learn more about the Moving Valgus Stress Test to assess knee ligament stability and diagnose injuries in patients with knee ligament length instability or ligamentous laxity.

Dial Test

Explore the Dial Test template from Carepatron to accurately assess and document knee instability, enhancing diagnostic precision in clinical settings.

Quality of Life Assessment

Empower patients & improve outcomes! Learn how Quality of Life (QoL) assessments provide valuable insights & benefit patients. Download our free template now.

Vancouver Scar Scale

Utilize our Vancouver Scar Scale template for precise burn scar assessments, enhancing treatment accuracy and educational outreach in medical settings.

No items found.

Join 10,000+ teams using Carepatron to be more productive

One app for all your healthcare work

Get Started

Modified Romberg Test & Example | Free PDF Download (2024)

References

Top Articles
Latest Posts
Article information

Author: Frankie Dare

Last Updated:

Views: 5964

Rating: 4.2 / 5 (73 voted)

Reviews: 88% of readers found this page helpful

Author information

Name: Frankie Dare

Birthday: 2000-01-27

Address: Suite 313 45115 Caridad Freeway, Port Barabaraville, MS 66713

Phone: +3769542039359

Job: Sales Manager

Hobby: Baton twirling, Stand-up comedy, Leather crafting, Rugby, tabletop games, Jigsaw puzzles, Air sports

Introduction: My name is Frankie Dare, I am a funny, beautiful, proud, fair, pleasant, cheerful, enthusiastic person who loves writing and wants to share my knowledge and understanding with you.