What is pronator drift?

An intensive neurological evaluation includes an assessment of the motor system, including body position, involuntary movements and coordination, in addition to muscle mass, tone and strength. The basic element is the pronator drift test, which helps assess motor function in a patient who’s conscious and capable of follow commands (Rank, 2013).

How to ascertain for pronator drift

The examination may be performed in a sitting or standing position. To perform the pronator drift test, ask the patient to shut their eyes after which hold each arms straight, palms facing up. Observe your arms for 20 to 30 seconds. The patient should have the option to keep up the identical position of each arms if their motor path is unbroken.

Positive pronator drift

Pronator drift occurs when one arm and hand rotate inward and downward. This indicates muscle weakness and abnormal function of the corticospinal tract, the upper motor neurons within the brain and spinal cord that control voluntary muscle movement, within the hemisphere opposite to the affected limb. The hand can remain up while the arm drops down and the fingers and elbow are bent. If the patient loses positional sense (proprioception), the arms may move sideways or upwards and the hands may curl. The patient is probably not aware of those movements and when asked to correct them, she or he is unable to correct the position appropriately.

If the arms remain raised evenly with none drift, use your fingers to vigorously tap the arms down. The arms should return to the horizontal position easily and easily, indicating adequate muscle strength, coordination and proper proprioception. If the patient has a scarcity of cerebellar coordination, the arm will jump up and lose its original starting position.

Pronator drift may occur following stroke or whiplash (Rank, 2013). Be sure to document signs of pronator drift, which shoulder is affected, and the direction of drift. Additional diagnostic tests similar to computed tomography or magnetic resonance imaging could also be needed, especially if this can be a recent finding (Rank, 2013).

Bickley, L. S., Szilagyi, P. G., Hoffman, R. M., & Soriano, R. P. (2021). Bate’s guide to physical examination and interviewing (thirteenth ed.). Wolters Kluwer Health: Philadelphia.

Hinkle, J. (2021). Brunner and Suddarth’s textbook of medical-surgical nursing (15^vol ed.). Wolters Kluwer Health. https://wolterskluwer.vitalsource.com/books/9781975161057

Rank, W. (2013). Assessment of pronator drift. (4), 66. https://doi.org/10.1097/01.NURSE.0000428333.01107.94