In assessing the tone of the lower limb, the knee and ankle joints are tested.
The hand is placed under one knee which is then flicked upwards to cause flexion. In a relaxed patient this should occur without resistance. A spastic leg will remain straight and land back on the bed on the heel of the foot.
Ankle clonus is tested for by sharply dorsiflexing the foot with the knee bent to 90ø and the hip externally rotated. Ankle clonus is seen as recurrent ankle plantar-flexed movements.
Patellar clonus is tested by resting the hand on the lower part of the quadriceps and moving the patella down sharply. Patellar clonus is seen as sustained rhythmical contraction of the quadriceps.
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