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Comparison of the tendon and plantar strike methods of eliciting the ankle reflex
  1. C E Clarke,
  2. P Davies,
  3. T Wilson,
  4. T Nutbeam
  1. Department of Neurology, City Hospital, Birmingham, UK
  1. Correspondence to:
 Dr C E Clarke, Department of Neurology, City Hospital, Dudley Road, Birmingham B18 7QH, UK; 
 c.e.clarke{at}bham.ac.uk

https://doi.org/10.1136/jnnp.74.9.1351

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    Little work has evaluated the various ways of eliciting the ankle reflex. A previous study of elderly patients with normal/absent reflexes found greater intraobserver and interobserver agreement with the plantar compared with the tendon strike method.1 Other studies showed that the reflex was best elicited in the kneeling position but moving comatose patients can be impossible or lengthy.2,3 We compared the reliability of the plantar and tendon strike methods of eliciting the ankle jerk in different disease states by examiners with different skill levels.

    Four patients with pathologically brisk reflexes, five with reduced/absent reflexes, and nine subjects with normal ankle reflexes, as judged by an experienced neurologist, were recruited. All subjects had symmetrical signs and gave written informed consent. Subjects were screened from examiners so that only their legs were …

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    Footnotes

    • Competing interests: none declared.