• An assessment for upper motor neuron disease.
• Before performing this exam, which can feel noxious, explain to the patient what you are doing and why – it may be helpful to demonstrate it in their hand.
• Stroke the lateral foot from the heel to the ball of the foot then across the ball of the foot(not all the way to the base of the toes) towards the big toe.
• The normal response is for the toes to plantar flex (downward).
• Dorsiflexion of the great toe (up going) and downward fanning of the other toes indicates disease in the upper motor neuron tract.