There is significant variability in methods used to perform neurological examination in poorlyresponsive patients. Inconsistent and poor inter-examiner reliability may lead to poor,consequential clinical decision-making and care. Noxious stimuli are routinely administered to elicit motoric responses to determine the depth of unresponsiveness in comatose patients. However, no study has tested the reliability of noxious stimuli delivery (NSD) method or quantified applied force that elicit motor responses in patients with coma.