Indications________
Cerebellar Function evaluation
Technique________
Patient starts seated or standing
Arms abducted at Shoulder to 90 degrees
Elbows flexed to 90 degrees
Examiner places their index finger at various locations in front of the patient
Finger is at a distance that requires patient to extend their elbow to reach the target
Patient uses their index finger on one hand
Patient touches their index finger to the examiner's finger
Patient then touches their index finger to their own nose
Repeat several times with the examiner moving their target finger each time
Patient repeats the process using the opposite hand's index finger
Additional testing: Eyes closed
Examiner holds finger in one place while patient repeats the test above
Patient closes their eyes and repeats the testing again
Precautions
Pitfalls______
Patient should not hold their arms adducted at their sides
Adduction allows the patient to "cheat", bracing their arm against their side
Masks Tremor
Interpretation________
Cerebellar dysfunction findings
Clumsy and unsteady movements
Finger may initially overshoot target, swinging side to side as it gets closer and finally reaches its target (measuring, dysmetria)
Intention Tremor (Action Tremor) may also be present as the finger gets closer to its target
Incoordination often worsens with eyes closed (suggesting position sense dysfunction)
Consistent dysmetria to one side (past pointing)
