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Rapid Alternating Movements

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(Redirected from Dysdiadochokinesia Test)

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Rapid Alternating Movements
(a) Finger to Nose Test, (b) Dysdiadochokinesia Test, and (c) Heel to Shin Test
Rapid Alternating Movements
Pronation and Supination for rapid alternating movements[1]
  • Rapid Alternating Movements Test
  • Dysdiadochokinesia Test
  • Rapid Alternating Movement Test (RAM Test)
  • Diadochokinesia Test
  • Rapid Alternating Hand Movements Test

Purpose

  • Assess cerebellar function, motor coordination, movement timing and rhythm
  • Identify dysdiadochokinesia
  • Compare coordination between sides

Description

  • Patient performs rapid alternating movements
  • Most common method is rapid pronation and supination of the hands
  • Typically, hands are alternated on the thighs
  • Examiner evaluates:
    • Speed
    • Rhythm
    • Accuracy
    • Symmetry
    • Smoothness of movement
  • Normal findings
    • Movements are rapid, smooth, rhythmic and symmetric
  • Abnormal Findings
    • Slow movements
    • Irregular rhythm
    • Clumsy movements
    • Inability to maintain speed or rhythm
    • Decreased movement amplitude
    • Asymmetry between sides

Alternative methods

  • Rapid finger tapping
  • Foot tapping
  • Toe tapping
  • Heel tapping
  • Pronation/Supination to opposite hand

Pathology

  • Cerebellar dysfunction
  • Cerebellar stroke
  • Cerebellar tumor
  • Multiple sclerosis
  • Spinocerebellar ataxia
  • Traumatic brain injury
  • Alcohol-related cerebellar degeneration
  • Parkinsonian syndromes
  • Neurodegenerative disorders affecting cerebellar pathways

Evidence

Focal Cerebral Hemisphere Lesions

  • Anderson et al[2]
    • Sensitivity: 30%
    • Specificity: 100%

Parkinsons Disease

  • Fimbel et al using diadochokinesimeters instead of clinical assessment[3]
    • Sensitivity: 100%
    • Specificity: 85%

See Also

References

  1. ↑ Image courtesy of neuopsykey.com
  2. ↑ Anderson, N. E., et al. "Detection of focal cerebral hemisphere lesions using the neurological examination." Journal of Neurology, Neurosurgery & Psychiatry 76.4 (2005): 545-549.
  3. ↑ Fimbel, Eric J., et al. "Automatic detection of movement disorders using recordings of rapid alternating movements." Journal of neuroscience methods 146.2 (2005): 183-190.
Created by:
John Kiel on 20 June 2026 11:43:11
Authors:
Last edited:
20 June 2026 17:43:15
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