Grading of muscle power and deep tendon reflexes

What it is

Two short rules carry most of the bedside exam: muscle strength is written out of 5, and the deep tendon reflexes out of 4. Muscle strength evaluation:

• 0/5 no contraction.
• 1/5 muscle flicker, but no movement.
• 2/5 movement, but not against gravity.
• 3/5 movement against gravity, but not resistance.
• 4/5 some movement against resistance.
• 5/5 normal strength.

Deep tendon reflexes:

• 0/4 no reflex.
• 1/4 trace reflex.
• 2/4 normal.
• 3/4 brisk reflex.
• 4/4 hyperactive reflex, with clonus.