Muscle Stretch Reflexes: The ankle reflexes will be examined using an appropriate reflex
hammer (e.g. Trommer or Queen square). The ankle reflexes should be elicited in the
sitting position with the foot dependent and the patient relaxed. For the reflex, the foot
should be passively positioned and the foot dorsiflexed slightly to obtain optimal stretch
of the muscle. The Achilles tendon should be percussed directly. If the reflex is
obtained, it is graded as present. If the reflex is absent, the patient is asked to perform the
Jendrassic maneuver (i.e., hooking the fingers together and pulling). Reflexes elicited
with the Jendrassic maneuver alone are designated “present with reinforcement.” If the