Pronator drift
In
Description
Assessing for pronator drift helps to detect mild upper limb weakness in a patient who's awake and able to follow directions. Ask the patient to close the eyes, then to stretch out both arms in the appropriate position: Flex the shoulder joint to 90 degrees (45 degrees, if supine) and fully extend the elbow joint. The palms should be facing up (supinated). The patient should maintain this position for 20 to 30 seconds. Observe both arms. If the motor pathway is intact, the arms should remain in this position equally. Patients with a slight weakness in one arm won't be able to keep the affected arm raised, and ultimately the palm may begin to pronate (palm facing down). Pronator drift indicates abnormal function of the corticospinal tract in the contralateral hemisphere. In some patients, the arm may remain supinated but drop lower than the unaffected arm, and the fingers and elbow might flex.[citation needed]
The patient is asked to hold both arms at 90 degree flexion and elbows fully extended at shoulder level in front of them, with the palms upwards, and hold the position. If they are unable to maintain the position the result is positive. Closing the eyes accentuates the effect, because the brain is deprived of visual information about the position of the body and must rely on proprioception. Tapping on the palm of the outstretched hands can accentuate the effect.[citation needed]
Interpretation
This is a test of upper motor neuron disease.[citation needed]
If a forearm
References
- PMID 15774443.
- ^ Pronator drift. gpnoebook.co.uk. URL: http://www.gpnotebook.co.uk/simplepage.cfm?ID=503709725. Accessed On: October 23, 2008.
- ^ "The Precise Neurological Exam". Archived from the original on 2009-04-29. Retrieved 2009-11-28.
External links
- Picture of pronator drift test position - pediatricneurology.com.