• Soojeong Shin, Eunjeong Park, Dong Hyun Lee, Ki-Jeong Lee, Ji Hoe Heo, and Hyo Suk Nam.
• Department of Neurology, Yonsei University College of Medicine, Seodaemoon-gu, Seoul, Korea.
• Plos One. 2012 Jan 1; 7 (7): e41544.

BackgroundThe pronator drift test is widely used to detect mild arm weakness. We developed an application that runs on a handheld device to objectify the pronator drift test and investigated its feasibility in stroke patients.MethodsThe iPronator application, which uses the built-in accelerometer in handheld devices, was developed. We enrolled acute ischemic stroke patients (n = 10) with mild arm weakness and healthy controls (n = 10) to validate the iPronator. In addition to conventional neurological examinations, the degree of average, maximum, and oscillation in drift and pronation were measured and compared using the iPronator. Follow-up tests using the iPronator were also conducted in the patient group one week later.ResultsThere was a strong correlation between the average degree of pronation and drift measured by the iPronator (r = 0.741, p<0.001). The degrees of average and maximum in pronation were greater in the patient group than in the control group [in average, 28.9°, interquartile range (IQR) 18.7-40.3 vs. 3.8° (IQR 0.3-7.5), p<0.001], in maximum, 33.0° (IQR 24.0-52.1) vs. 6.2° (IQR 1.4-9.4), p<0.001]. The degree of oscillation in pronation was not different between the groups (p = 0.166). In drift, the degrees of average, maximum, and oscillation were greater in the patient group. In stroke patients, a follow-up study at one week revealed improvements in the degrees of pronation and drift compared with baseline parameters.ConclusionsThe iPronator can reliably detect mild arm weakness of stroke patients and was also useful in detecting functional recovery for one week in patients with acute stroke.

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