Execution:
- Patient is in supine position
- Run a pointed object from the heel along the lateral aspect of the foot towards the great toe
- Normal outcome: Flexor reflex / Grasping reflex of the toes (toe flexion)
Positive Outcome: Extension of the big toe and abduction of the other toes (Fan sign)
| Study | Reliability | Sn | Sp | LR+ | LR- |
| Isaza Jaramillo et al. (2014) | Inter ĸ=0.73 Intra ĸ =0.57 |
51 | 99 | 51.8 | 0.5 |
| Cook et al. (2009) | ĸ=0.56 | 33 | 92 | 4.0 | 0.7 |
| Prabhakar et al. (2018) | Inter-rater κ=0.45 | 49.6 | 85.8 | 3.49 | 0.59 |
| Comment: Performed individually this test is not effective for screening, however it alters the post-test probability more than combinations of test findings (Cook et al. 2009) | |||||
