is being tested (e.g., slight plantar flexion by pushing the ball of the foot against the floor or the examiner’s hand to reinforce the ankle jerk). The patient may tense the quadriceps by extending the knee slightly against resistance as the knee jerk is being elicited. Reinforcement may increase the amplitude of a slug- gish reflex or bring out a latent reflex not otherwise obtainable. Reflexes that are normal on reinforce- ment, even though not present without reinforce- ment, may be considered normal. Slight muscle contraction due to inability to relax may be one rea- son for the slightly hyperactive reflexes often seen in patients who are tense or anxious.The DTRs are instrumental in the evaluation of weakness. Under most circumstances, weakness accompanied by hyporeflexia is of lower