Disclosure: The opinions expressed and conclusions arrived at are those of the author and are not necessarily to be attributed to the NRF.
The accuracy of subjective clinical assessments of the patellar reflex†
Article first published online: 21 NOV 2012
Copyright © 2012 Wiley Periodicals, Inc.
Muscle & Nerve
Volume 47, Issue 1, pages 81–88, January 2013
How to Cite
Dafkin, C., Green, A., Kerr, S., Veliotes, D. and Mckinon, W. (2013), The accuracy of subjective clinical assessments of the patellar reflex. Muscle Nerve, 47: 81–88. doi: 10.1002/mus.23487
- Issue published online: 15 DEC 2012
- Article first published online: 21 NOV 2012
- Accepted manuscript online: 11 JUN 2012 12:00AM EST
- Manuscript Accepted: 4 JUN 2012
- change of knee angle;
- patellar reflex;
- reflex rating scales;
Introduction: Measurement precision and accuracy of spinal reflexes plays an essential role in the clinical neurological examination. Reflexes are conventionally assessed either electromyographically or with rating scales. In this study we compared objective kinematic T-reflex and subjective assessments of patellar reflexes in 15 normal healthy subjects. Methods: Randomized recordings of objectively quantified reflexes were rated by 24 medical students, 16 general practitioners, and 12 neurologists, using a visual analog scale and the NINDS and Mayo clinical reflex scales. Results: For all groups of raters, Spearman rank correlations showed that subjective ratings significantly correlated with change of knee angle (R2 = 0.72–0.79, P < 0.001) and maximum T-reflex amplitude (R2 = 0.84–0.94, P < 0.001). Stepwise multiple regression analysis showed that all subjective rater groups relied most on the change of knee angle to assess the reflex. Conclusions: These findings show that subjective assessments of reflexes using reflex rating scales correlate strongly with biomechanical and electromyographic measures. Muscle Nerve, 2013