RELIABILITY OF THE NINDS MYOTATIC-REFLEX-SCALE

The assessment of deep tendon reflexes is useful for localization and diagnosis of neurologic disorders, but only a few studies have evaluat ed their reliability. We assessed the reliability of four neurologists , instructed in two different countries, in using the National Institu te of Neurological Disorders and Stroke (NINDS) Myotatic Reflex Scale. To evaluate the role of training in using the scale, the neurologists randomly and blindly evaluated a total of 80 patients, 40 before and 40 after a training session. Inter- and intraobserver reliability were measured with kappa statistics. Our results showed substantial to nea r-perfect intraobserver reliability, and moderate-to-substantial inter observer reliability of the NINDS Myotatic Reflex Scale. The reproduci bility was better for reflexes in the lower than in the upper extremit ies. Neither educational background nor the training session influence d the reliability of our results. The NINDS Myotatic Reflex Scale has sufficient reliability to be adopted as a universal scale.