When assessing for arm drift in suspected stroke, which step is recommended?

• A. Observe movement of arms for approximately 2 minutes.
• B. Expect to see one arm slowly drift down to the patient's side.
• C. Ask the patient to close his or her eyes during the assessment.
• D. Ask the patient to hold his or her arms up with the palms down.

Answer: (C)

Closing the eyes during the arm drift check helps reveal a true motor deficit. When the patient can see, visual input and the ability to visually correct position can mask subtle weakness. By having the patient close their eyes, you remove that compensatory feedback and allow any unilateral weakness to cause the arm to drift downward, making the deficit easier to detect quickly. This test is done with the arms extended and held for roughly 5–10 seconds to observe for drift. Long observation times or different hand positions aren’t reliable for this quick screen, and keeping the eyes open can hide drift.