Introduction
Grades of reflex intensity are used for such purposes as to classify and group, to provide accurate and reproducible data, and to decrease intra-observer variability. Across the continuum of healthcare disciplines, it is projected that the number of deep tendon reflex grading scales easily exceeds 30 named and anecdotal scales.
This said, documenting grades of reflex intensity using a widely accepted scale that offers validated criteria is recommended. Cumulatively, all scales seek to identify the range of possible normal responses, the absence of a normal response, exaggerated responses, and/or a range of exaggerated responses. Additionally, many scales encourage the use of added descriptions that will allow the clinician to better communicate clinical examination findings. Deep tendon reflexes are typically rated according to the following scale:
| Grade | Response |
| 0+ | No response or absent reflex |
| 1+ | Trace or decreased response |
| 2+ | Normal response |
| 3+ | Exaggerated or brisk response |
| 4+ | Sustained response |
