1. Examine the patient’s arms during movement by doing the finger-nose test, looking for tremor during movement (kinetic tremor) and any clear worsening at the end points (intention tremor).
  2. Consider testing: pour water between cups, draw spirals, or write a sentence.
  3. Compare severity of kinetic tremor to that seen during sustained posture.
  4. Note whether dystonic movements or postures are present (eg, do some of the fingers flex, extend, or twist during the finger-nose-finger manoeuvre)?