ABSTRACT
Positions patient appropriately, exposing both legs Inspects lower limbs – looking for wasting and fasciculation Assesses legs for tone, including testing for ankle clonus if tone is increased Tests power of hip flexion Tests power of hip extension Tests power of knee flexion Tests power of knee extension Tests power of ankle dorsiflexion Tests power of plantar flexion Tests power of eversion of forefoot Tests power of inversion of forefoot Assesses reflexes (knee, ankle and plantar) with reinforcement if necessary Tests light touch and pinprick sensation in all dermatomes Tests vibration sense and proprioception Tests heel-shin coordination Observes gait-comments on posture, arm swing, step size and equality, ataxia and circumduction Performs Romberg’s test
Cleans hands by washing or using alcohol gel
Fluency of examination Competence in presenting findings, summarizing and forming differential diagnoses
KEY Start the examination with your patient lying in a semi-prone position with the legs fully exposed, asking him/her to stand at the end to assess gait and perform Romberg’s test.
