Tone
Ask the patient to keep their legs fully relaxed and “floppy” throughout your assessment.
1. Leg roll – roll the patient’s leg and watch the foot – it should flop independently of the leg
2. Leg lift – briskly lift leg off the bed at the knee joint – the heel should remain in contact with the bed
3. Ankle clonus:
Position the patient’s leg so that the knee and ankle are slightly flexed, supporting the leg with your hand under their knee, so they can relax.
Rapidly dorsiflex and partially evert the foot
Keep the foot in this position
Clonus is felt as rhythmical beats of dorsiflexion/plantarflexion (>5 is abnormal)
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