THE PLANTAR REFLEX - RePub

CONCLUSIONS
1. The term 'plantar reflex' was known long before Babinski studied the
toe responses, and stood for flexion in ankle, knee and hip following
stimulation of the sole.
2. Toe movements were occasionally noted as part of the plantar reflex,
but these received little attention and it was a common belief that
dorsiflexion was found in health as well as in disease.
Babinski discovered that plantar flexion of the toes was the normal
response, and that the reverse phenomenon, of the great toe in
particular, occurred only in patients with affections of the pyramidal
tract (as opposed to hysterical weakness) and in infants.
3. Abduction of the small toes following stimulation of the sole was one
of the many accessory pyramidal signs noticed by Babinski. He did not
regard it as indispensable for a pathological plantar reflex, nor does
this follow from any objective study, and it is misguided traditionalism
to think so.
4. In the Netherlands the normal plantar flexion of the toes is erroneously
linked with the name of von Strumpell.
5. The upgoing toe sign is intimately related to the flexion synergy of the
lower limb; that the (anatomical) toe extensors are flexor muscles in a
functional sense (and vice versa) is corroborated by Sherrington's
animal experiments.
6. A Babinski sign without concomitant reflex effects in more proximal
muscles appears to be rare; the reverse is common.
7. The normal plantar response is a unisegmental reflex, comparable to
abdominal and cremasteric reflexes.
8. The numerous alternative methods of producing an upgoing toe sign,
often advanced as competitive signs, all stem from a basic misunderstanding
of its intimate relationship with the flexion reflex; that this
entire synergy could be evoked by various superficial and deep stimuli
had been known for a long time.
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