Muscle power and Deep Tendon reflexes grading

MRC Scale
Grade	Description
0	no contraction
1	flicker or trace of contraction
2	active movement with gravity eliminated
3	active movement against gravity
4*	active movement against gravity and resistance
5	normal power

Reflexes are graded using a 0 to 4+ scale:

Grade Description
0	absent
1+	hypoactive
2+	normal
3+	hyperactive without clonus
4+	hyperactive with clonus

Babinski Response

• explain the examination technique to the patient and ask them to relax.
  
• stroke the lateral aspect of the sole of each foot and then come across the ball of the foot medially with a sharp object.

Clonus
If reflexes are hyperactive, test for ankle clonus.

• ask the patient to relax.
  
• support the knee in a partly flexed position.
  
• quickly dorsiflex the foot and observe for rhythmic clonic movements.

http://neuroexam.med.utoronto.ca/motor_4.htm

http://neuroexam.med.utoronto.ca/motor_6.htm