Pronator Drift Test

Learn about Pronator Drift and what the Pronator Drift Test is by reading this mini-guide.

By Matt Olivares on Jul 15, 2024.

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Fact Checked by Ericka Pingol.

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What is Pronator Drift?

During comprehensive neurological examinations, neurologists will look for certain signs to determine what possible neurological disorder a person has. One of the signs that they will look out for is Pronator Drift.

Pronator Drift is a pathological sign that points toward palsy. It also emerges as a result of an upper motor neuron lesion, which is an injury to the brain or spine that can be the result of several conditions like cerebral palsy, stroke, traumatic brain injury, and even multiple sclerosis. It is also a sign that there is an abnormality in the corticospinal tract. The corticospinal tract is responsible for voluntary distal movements. If this tract becomes injured or compromised in some way, muscles on the side of the body become weaker and can have an increased tone, which results in the presence of Pronator Drift.

If a person has Pronator Drift, there is an involuntary rotation of their forearm and palm. They will move downward (the pronation) if they extend their arms forward and attempt to keep them in the same position for tens of seconds.

To assess the presence of Pronator Drift in patients, the was created. In the next section of this guide, you will learn how it works. It’s quite easy.

How to conduct the Pronator Drift Test

The Pronator Drift Test is one of the most inexpensive components of a comprehensive neurological exam because it doesn’t require any special equipment to conduct and perform. The only requirements are the following:

  • A patient who is awake and can follow directions
  • A chair for your patient, though this is optional because you can conduct this test with them standing up or sitting down
  • A stopwatch

Those are the only things that you need! Once you’re ready, explain the purpose of this test to the patient, and when they’re ready, instruct them to do the following:

  • Have them sit down or stand up. Go with what’s comfortable for your patient
  • Tell them to close their eyes and to keep them closed until the test is over
  • Have them extend their arms forward and keep their hands supinated (their palms should be facing up)
  • The patient needs to keep their arms in place for twenty to thirty seconds
  • Observe their arms and do make sure that you’re using a stopwatch to time the test for twenty or thirty seconds

Depending on your observations, the patient will test positive or negative.

If the patient can maintain the position of their arms for the duration of the Pronator Drift Test, then you can say that their motor function is intact and they’re negative. Though, before you designate them as negative, you can further test their arms by tapping them downward with your fingers briskly. If their arms return to their original position, you can say they are truly negative because they have exhibited good muscle strength, a normal level of proprioception, and regular coordination. If the arm bounces upward and misses their starting point, that might be a sign they have cerebellar incoordination, so you’ll have to designate them as positive.

If one of their arms turns inward and moves downward or drifts to the side, have your patient correct their arm positioning while keeping their eyes closed. They’re already positive if the arm turns inward and downward or drifts to the side. All the more if they can’t correct the position.

After this test, it’s best to conduct other neurological tests to check for other possible pathological signs and problems.

When is the best time to conduct a Pronator Drift Test?

Above, we mentioned that you should also conduct other neurological tests to check for other problems. The reason we mentioned that is that the Pronator Drift Test is not enough on its own to say that patients have neurological problems. It shouldn’t be used as the sole test for diagnosing someone with a neurological condition. 

The best time to conduct the Pronator Drift Test is during a comprehensive neurological examination that involves other tests. This is so you can get the best and most comprehensive results possible. Comprehensive neurological examinations can help professionals cover as much ground as possible and narrow down potential problems before making official diagnoses.

This is not to say that the Pronator Drift Test is unreliable. It is reliable because the signs you need to look out for during this test are specific, and if they are present, then your patient potentially has neurological problems that need to be addressed. The same thing goes for other neurological tests. They are reliable, but not on their own, and their respective results should not be the sole basis for a diagnosis.

What are the benefits of the Pronator Drift Test?

It’s a quick and easy test to conduct.

The Pronator Drift Test is an inexpensive neurological test because it only requires you to give instructions to a patient, and the patient just needs to follow them. The instructions are simple enough that there should be no problem doing it. The test also runs for twenty or thirty seconds, making it one of the quickest tests you can conduct.

It can help guide treatment decisions down the line.

One of the best things about the Pronator Drift Test is that the signs that professionals will observe will give them information about the states of neural pathways that influence motor control. By identifying the direction of the Pronator Drift and how severe the drift is, professionals will be able to localize the lesion that the patient has. Knowing the location of the lesion can aid in the diagnostic process, and treatment can be guided accordingly.

It can be used to monitor the progression of the patient’s neurological condition.

For the sake of example, let’s say you have made an official diagnosis for your patient and you’ve implemented a care plan for them. It’s only natural for you to want to know how they’re doing, if their neurological condition is being managed well, or if it’s progressing further. One way to do it is to schedule routine checkups with your patient and conduct the Pronator Drift Test again.

If their drifts are more severe than before, the condition has progressed, and perhaps your plan isn’t working, so it’s best to make some tweaks to see if the changes will work. If the severity of their drift is noticeably less than when you first conducted the test, or if there’s no drift at all, you can safely assume that your patient is getting better (no matter how slowly) and that your plan is working.

How long does it take to accomplish the Pronator Drift Test?
How long does it take to accomplish the Pronator Drift Test?

Commonly asked questions

How long does it take to accomplish the Pronator Drift Test?

The actual test only takes 20 to 30 seconds to complete. This doesn’t count the preparation and recording of the results.

Is the Pronator Drift Test painful?

No, but it can cause discomfort. Your patient will be maintaining a position where their arms are extended for 20 to 30 seconds. Most people can handle that, but some people can’t and may feel tired during the test.

Is the Pronator Drift Test a diagnostic test?

It helps with diagnoses, but it doesn’t exactly diagnose anything because it only confirms the possibility of certain conditions and the potential lesions that a patient has based on the severity of the drift. Other tests, especially imaging tests, will confirm the actual problems.

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