A variety of clinical tests are used to detect a subtle upper motor neuron lesion but only a few studies have measured their sensitivity and specificity. The forearm rolling test and its variant, the finger rolling test, is one such. These tests are simple and only take 5–10 s to perform. Their sensitivity has varied in different studies but in general both are more likely to be abnormal in a patient with a focal brain lesion than abnormal power, tone and reflexes. The finger rolling test is more sensitive than forearm rolling. Furthermore, an abnormal response on testing forearm and finger rolling has a high specificity for the presence of a focal brain lesion.
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