Forearm Rolling Test for Stroke

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4 thoughts on “Forearm Rolling Test for Stroke

  1. Brandon O says:

    I gusta this mucho. It seems like the rolling tests would also include some degree of cerebellar testing (e.g. for dysdiadochokinesia), due to the coordination and rapid cycling involved — which seems good for sensitivity although perhaps not for specificity. (But a positive cerebellar sign would perhaps present differently — rather than unilateral immobility, more of a general sluggishness or ataxia in the movement.) Things to ponder.

    I do have some doubts as to ease of compliance… in the really elderly and comorbid patients, even the arm drift test can be a bit challenging to pull off. I suspect that getting them to do the cha-cha may require, let us say, a fairly low expectation of baseline performance.

    • Vince D says:

      I had the same thoughts in regards to cerebellar testing, and I wonder if having the patient close their eyes would increase the yield by really testing the patient’s proprioception.

      You second point is also a valid one. I’ve been using this for maybe two years now with most patients I test being able to perform it well enough, but my experience is very skewed because there’s been a good deal of selection bias. I’ve purposely skip it on less cooperative patients because I wasn’t that interested in forcing the issue, but I think from here on out everyone getting a CPSS will also attempt an arm roll.

      I’ve been surprised in a few cases when some unexpected patients were able to follow this even though they had fairly progressive dementia, and I think it might have something to do with the active participation required of the test. Tell them to hold their hands out, and they drift off for a nap within two seconds, but get them actively involved in moving their arms and they tend to stick with you for a little bit. Changing direction can require a couple of tries, and there’s a whole lot of patients whose attention you cannot keep for long enough to even get them to lift up their arms in the first place, but a select few may surprise you.

      • Brandon O says:

        If you’ve had good luck with it, then I believe it. I wonder how necessary it is to try both directions. Doesn’t seem like the neuromotor pattern would be all that different.

    • Christopher says:

      The Conga Line Test is an easy and fun test to administer at home, in a skilled nursing facility, or in the back of your ambulance! We recommend playing some Buena Vista Social Club to really set the mood.

      In all seriousness this is wonderful and I think it is far easier to administer than the standard arm drift. At 3am nobody likes to remember palms up versus palms down…

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