Physical examination maneuver

Physical Exam

Pronator Drift

🎬
Video coming September 2026

How to Perform

Ask the patient to hold both arms outstretched in front, palms up (supinated), then close the eyes and hold the position for 20–30 seconds. A positive test is downward drift of one arm with pronation of the forearm (the palm turning inward and down).

How to Interpret

Showing 3 of 4 findings

Brain Tumor

Pronator drift positive
Rule in
Very helpful
Rule out
Minimally helpful
Evidence:Limited

Stroke

Pronator drift positive (downward drift with pronation of the supinated, outstretched arm sustained for 45 seconds, eyes closed)
Rule in
Helpful
Rule out
Very helpful
Evidence:Limited

Upper Motor Neuron Lesion

Pronator drift positive (downward drift with pronation of the supinated, outstretched arm sustained for 45 seconds, eyes closed)
Rule in
Not helpful
Rule out
Not helpful
Evidence:Limited

References

  • Teitelbaum JS, Eliasziw M, Garner M. Tests of motor function in patients suspected of having mild unilateral cerebral lesions. Can J Neurol Sci. 2002 Nov;29(4):337-344. doi:10.1017/S0317167100002201. PMID 12463489.
  • Anderson NE, Mason DF, Fink JN, Bergin PS, Charleston AJ, Gamble GD. Detection of focal cerebral hemisphere lesions using the neurological examination. J Neurol Neurosurg Psychiatry. 2005 Apr;76(4):545-549. doi:10.1136/jnnp.2004.043679. PMID 15774443. PMC1739581.
  • Maranhão ET, Maranhão-Filho P, Lima MA, Vincent MB. Can clinical tests detect early signs of monohemispheric brain tumors? J Neurol Phys Ther. 2010 Sep;34(3):145-149. doi:10.1097/npt.0b013e3181e5c10e. PMID 20799429.
  • McGee S. Evidence-Based Physical Diagnosis. 6th ed. Philadelphia, PA: Elsevier; 2025.

Related Systems / Regions

NeurologicalUpper Extremities

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