The method of elicitation:
The patient lies supine with extended legs and relaxation of the muscles of the lower limbs.
Hold one leg firmly above the knee joint with your left hand in such a way so the toes of the foot look towards the roof.
The outer border of the sole is then stretched gently but firmly by the tip of a key.
Starting from the heel, go along the lateral border towards the little toe and then turn medially across the metatarsal pad up to the head of 2nd metatarsus (never touch the ball of the great toe and the flexor creases of the toes) in a semicircular fashion.
Normal plantar response:
Flexion of all the 5 toes
Babinski’s sign (extensor plantar response):
Extension of the great toe (extension of great toe after a brief initial flexion is not extensor response)
Fanning (spreading out) and extension of outer 4 toes
Dorsiflexion of the ankle, & flexion of the knee and the hip
In hemiplegia / paraplegia (i.e. UMN lesion), the plantar response remains extensor life-long.
Root value of plantar reflex is s₁
Afferent & efferent nerve of plantar reflex:
The afferent nerve of plantar reflex = tibial nerve
The efferent nerve of plantar reflex is tibial nerve for flexor response and peroneal nerve for extensor response.
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