Rapid Alternating Movements
Other Names
- 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
- ↑ Image courtesy of neuopsykey.com
- ↑ 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.
- ↑ 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
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Last edited:
20 June 2026 17:43:15
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