DEEP TENDON REFLEXES

MUSCLES GRADING
Biceps 0 - no response
Triceps 1 + - hyporeflexia
Brachioradialis 2+ - normoreflexia
Patellar 3+ - hyperreflexia
Achilles 4+ - clonus

LEG LENGTH MEASUREMENT

TRUE LLD ASIS → Medial Malleolus

APPARENT Umbilicus → Medial Malleolus

Greater Trochanter → Lateral

Condyle
SEGMENTAL
Medial Condyle → Medial Malleolus

LIMB GIRTH

Knee
● 2 in. below
● 4 in. below
● 6 in. below
Hand
● Figure of 8

MODIFIED ASHWORTH SCALE

0 - No increase in muscle tone

1 - Slight increase in muscle tone, (+) Catch and release,
Minimal resistance at
end of ROM
1+ - Slight increase in muscle tone, (+) Catch and
release, Minimal resistance
throughout ROM
2 - Marked increase in muscle tone, Parts still easily
moved
3 - Considerable increase in muscle tone. Passive
movement difficult
4 - Rigid

MUSCLE TONE ASSESSMENT

0 - Flaccid
1+ - Hypotonia
2+ - Normotonia
3+ - Mild to Mod. Hypertonia
4+ - Severe Hypertonia

TARDIEU SCALE

0 - No resistance
1 - Slight resistance, No clear catch at a precise angle
2 - (+) Clear catch at a precise angle, Followed by
release
3 - Fatigueable clonus (< 10 seconds)
4 - Non-Fatigueable clonus (> 10 seconds)
5 - Immoveable
 GLASGOW COMA SCALE

Eye Opening Verbal Response Motor Response

5 - obeys
commands
5 - oriented
4 - 4 - localizes pain
4 - confused
spontaneous 3 - withdraws
3 - inapp. words
3 - to sound from pain
2 - incomp.
2 - to pressure 2 - decorticate
sounds
1 - none 1 - decerebrate
1 - none
0 - none

PATHOLOGIC REFLEXES

stroking the lateral dorsiflexion of

aspect of the sole the big toe with
Babinski of the foot from the fanning out or
heel to the ball and abduction of the
across the forefoot small toes

sudden dorsiflexion sustained jerking

Clonus
of the foot of the foot

BABINSKI-LIKE RESPONSES

stroke the lateral

Chaddock’s
malleolus

squeeze the calf

Gordon’s
area

firm downward
dorsiflexion of
stroking of the tibia
Oppenheim’s the big toe with
and tibialis anterior
fanning out or
muscle is done
abduction of the
small toes
press one the other
toes downward and
Gonda
releases it with a
snap

squeeze the
Schaeffer’s
Achilles tendon
 STROKE

Glasgow Coma Scale

Neuromuscular Gait Analysis
Balance

Deep Tendon Reflexes

Biceps (innervated by C5 and C6)
Radial brachialis (by C6)
Triceps (by C7)
Distal finger flexors (by C8)
Quadriceps knee jerk (by L4)
Ankle jerk (by S1)
Motor Function
Jaw jerk (by the 5th cranial nerves)

Pathologic Reflexes
Babinski reflexes
Chaddock reflexes
Oppenheim reflexes
Hoffmann sign

MMT
Musculoskeletal ROM
Trigger Points

Vital sign measurement

Pulse palpation
Auscultation
Vein observation
Chest inspection, and palpation
Cardiovascular/
Cardiac percussion, palpation, and
Pulmonary
auscultation
● Lung examination
○ Percussion
○ Palpation
○ Auscultation

Inspection/Observation/Palpation
Skin color
Skin temperature
Integumentary Moisture level
Skin turgor
Any lesions or skin breakdown
Capillary Refill

FRACTURE

Gait Analysis
Berg Balance Scale
ROM
MMT
Limb Girth
Muscle Bulk Test
Assessments
LLD
Weber-Barstow Maneuver
Postural Assessment
Sharp/Dull Discrimination
Light Touch
Pressure Perception

Metatarsal Loading Test: metatarsal fx

Special Tests Tap/Percussion Test: LE fx
Vibration Test: stress fx
 Fulcrum Test: stress fx of femoral shaft

ROM (AROM & PROM)

MMT
Cranial Nerve Examination
- 2,3,5,7,9,10,12
Sensory Examination (superficial & deep)
Cognition (MMSE)
Pain
- McGill Pain Q., Neuropathic P/S,
Lhermitte’s Sign
Fatigue
- Modified Fatigue Impact Scale,
Fatigue Scale for Motor and
Cognitive Functions
Assessments
Temperature Sensitivity
Motor Function (MAS)
Deep Tendon Reflex
Pathological Reflex
- Babinski
Postural Analysis
Gait Analysis
Balance
- Berg Balance
- BESTest
Functional Assessment
- Functional Independence
Measure

LOW BACK PAIN

Lumbar AROM
MMT
- Trunk Flexors
- Trunk Extensors
- Lateral Abdominals
Assessments
- Hip Abductors
- Hip Extensors
Passive Hip Internal Rotation, External
Rotation, Flexion, and Extension
Oswestry Disability Index

SLR
Special Tests
Slump Test

SCOLIOSIS

Assessments Postural Analysis (APL)

Slump Test
Special Tests Lhermitte’s Sign
Adam’s Forward Bend Test