Place the patient in a seated or standing position and ask them to close their eyes. The finger-to-nose test assesses equilibrium and coordination. In some patients, the arm may remain supinated but will drop lower than the unaffected arm. Patients with weakness in one arm will not be able to keep the affected arm raised, and ultimately the palm may begin to pronate (palm facing down). If the patient is unable to maintain the position, the result is referred to as a positive pronator drift test. The expected finding is both arms will maintain this position equally. ![]() Proprioception is the awareness of body position and movement. 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. The patient should try to maintain this position for 20 to 30 seconds. Ask the patient to close their eyes and extend both arms at 90 degrees at shoulder level with the palms facing upwards. When feasible, obtain the patient’s baseline ability and compare current findings to their baseline.įigure 6.32 Assessing Gait and Balance Pronator DriftĪssessing for pronator drift helps to detect mild upper limb weakness. When performing assessment of gait and balance, be aware that the older patient may have a mild degree of muscle weakness or decreased balance associated with aging. See Figure 6.32 for an image of assessing gait and balance. A change in gait, weakness, shuffling, jerky movements, loss of balance, or incoordination of arm swing can indicate a neurological dysfunction. Steps should be equal with a regular pace while arms are swinging and coordinated with walking. Look straight ahead and walk heel to toe.When assessing gait and balance, ask the patient to perform the following actions, using an assistive device if needed: Specific tests used to evaluate cerebellar function include assessment of gait and balance, pronator drift, the finger-to-nose test, rapid alternating action, and the heel-to-shin test. ![]() The cerebellum is responsible for equilibrium, coordination, and the smoothness of movement. ![]() The neurological aspect of motor function is based on the activities of the cerebellum.
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