Plantar response

Check that the big toe is relaxed. Stroke the lateral aspect of the sole and across the ball of the foot. Note the first movement of the big toe. Flexion should occur. Extension due to contraction of extensor hallucis longus (a 'Babinski' reflex) indicates an upper motor neuron lesion. This is usually accompanied by synchronous contraction of the knee flexors and tensor fasciae latae.

Elicit Chaddock's sign by stimulating the lateral border of the foot. The big toe extends with upper motor neuron lesions.

To avoid ambiguity do not touch the innermost aspect of the sole or the toes themselves.

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