ANKLE REFLEXES: PLANTAR STRIKE IS A BETTER TEST IN THE ELDERLY.

Examiners have noted absent ankle jerks in as few as 1 percent and as many as 76 percent of elderly patients. Part of this variation may result from the technique used to elicit the ankle jerks. This study compared the conventional Achilles tendon strike with the plantar strike. In the latter technique, the patient's legs lay side by side and the foot is passively dorsiflexed; the reflex hammer strikes the examiner's own fingers, which are placed over the plantar surface.

Eight physicians with different levels of experience examined 12 elderly patients using both techniques, grading ankle jerks as either present or absent. Both intra-observer and inter-observer agreement were significantly greater with the plantar strike technique.