We first just want to take the arm and make sure it is relaxed.
-“Move your arm, go like this as fast as you can. Move your hands fast, fast, fast.”
With normal tone the hands move quickly, if there were abnormal tone, one hand would be stiffer, would move more slowly. The next thing we do is:
-“Just relax your hand and quickly turn the wrist, and there is no catch to it, there is no increased tone. It’s normal tone, there is no catch to it. If it were abnormal, there might be a subtle spastic catch we call it. Twist the arm quickly and there is a little hesitation and then it goes. Now, to test tone in the legs, the best way to do it is have the patient relax.
-“Just relax for a second, okay? And lift the leg up.”
-“No, relax, relax.”
The reason why I said “no, relax” is when I lifted that leg, the heel came up. When the heel comes up, either he’s got abnormal tone, increased tone, or he’s not relaxed, because his muscles are contracting. So:
-“Relax.”
And that’s normal. When I lifted it up, the heel stayed on the bed the entire way. When I let go, the heel stayed on the bed. An abnormal tone, such as an increased tone, would result in the leg, when I let go, the leg went up and then coming down.