Changes in 2 or more deep tendon reflexes is a red flag item.

Changes in 2 or more deep tendon reflexes is a red flag item.

• A. Yes
• B. No
• C. Only increased
• D. Only decreased

Answer: (A)

Changes in two or more deep tendon reflexes are a red flag because they point to neurological involvement rather than a purely musculoskeletal issue. Deep tendon reflexes (like the biceps, brachioradialis, and triceps in the upper limb, and the patellar and Achilles in the lower limb) are expected to be symmetric and within a normal range. When two or more of these reflexes are abnormal—whether increased (hyperreflexia) or decreased (hyporeflexia)—it suggests something affecting the nervous system more globally, such as a spinal cord lesion, central nervous system disease, nerve root or peripheral nerve pathology, or polyneuropathy. This warrants referral or urgent medical evaluation rather than continuing with routine PT management. A single reflex change can occur from technique or variability, but two or more changes raise the likelihood of a true neuro pathology.

Changes in two or more deep tendon reflexes are a red flag because they point to neurological involvement rather than a purely musculoskeletal issue. Deep tendon reflexes (like the biceps, brachioradialis, and triceps in the upper limb, and the patellar and Achilles in the lower limb) are expected to be symmetric and within a normal range. When two or more of these reflexes are abnormal—whether increased (hyperreflexia) or decreased (hyporeflexia)—it suggests something affecting the nervous system more globally, such as a spinal cord lesion, central nervous system disease, nerve root or peripheral nerve pathology, or polyneuropathy. This warrants referral or urgent medical evaluation rather than continuing with routine PT management. A single reflex change can occur from technique or variability, but two or more changes raise the likelihood of a true neuro pathology.