There is an important nuance that distinguishes the finger to nose test from the rapid finger following test. The ataxia community has reached consensus on this, as reflected in the #ataxia rating scales - ICARS, SARA, and BARS. https://twitter.com/phil_bilodeau/status/1353023882819731461
For the finger to nose test, examine his finger is maintained in a stable position. The patient uses their index finger to reach for the examiner’s finger, and then reaches for their own nose. This screens for end-point dysmetria, and isolation at the elbow.
The rapid finger following test looks for overshoot / hypermetria or undershoot / hypometria, a sensitive indicator of cerebellar motor control, as though the spring is too loose. Examiner moves finger rapidly in horizontal / vertical planes. Patient mirrors the movement.
It is best to keep these tests of upper extremity control separate, otherwise you conflate the two evaluations, namely dysmetria (finger to nose test) and overshoot (rapid finger following test).
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