Hoovers Sign (Neurological): Difference between revisions
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== Purpose == | == Purpose == | ||
The purpose of the test is to distinguish between leg paresis that is psychogenic from that which is genuine. Genuine leg weakness seen in paresis is considered to be "organic," and other causes of leg paresis that is not related to a neuropathological process is considered to be "nonorganic."<ref name="Ziv"/> | The purpose of the test is to distinguish between leg paresis that is psychogenic from that which is genuine. Genuine leg weakness seen in paresis is considered to be "organic," and other causes of leg paresis that is not related to a neuropathological process is considered to be "nonorganic."<ref name="Ziv" /> | ||
== Technique == | == Technique == | ||
Hoover's sign is a motor sign. It is based on the principle of crossed extensor reflex. The patient is placed in a supine/recumbent position. The examiner places his/her hand under the patient's heel. The patient is then instructed to press the heels down onto the table. The examiner is expected to feel pressure on the non-paretic limb. The patient is then asked to raise his/her non-paretic limb against downward resistance applied by the therapist. No pressure is expected to be felt under the paretic leg that is on the table.<ref name="Ziv">Ziv, I., Djaldetti, R., Zoldan, J., Avraham, M., Melamed, E. (1998). Diagnosis of "non-organic" limb paresis by a novel objective motor assessment: The quantitative Hoover's test. Journal of Neurology, 245: 797-802.</ref> The Hoover's sign is when pressure is felt the paretic leg when the non-paretic leg is raised and no pressure is felt in the non-paretic leg when the paretic leg is being raised.<ref>Kaufman, D.M. (2007). Clinical neurology for psychiatrists: 6th edition. Elsevier Health Sciences. p. 20.</ref> | '''Hoover's sign''' is a motor sign. It is based on the principle of crossed extensor reflex. The patient is placed in a supine/recumbent position. The examiner places his/her hand under the patient's heel. The patient is then instructed to press the heels down onto the table. The examiner is expected to feel pressure on the non-paretic limb. The patient is then asked to raise his/her non-paretic limb against downward resistance applied by the therapist. No pressure is expected to be felt under the paretic leg that is on the table.<ref name="Ziv">Ziv, I., Djaldetti, R., Zoldan, J., Avraham, M., Melamed, E. (1998). Diagnosis of "non-organic" limb paresis by a novel objective motor assessment: The quantitative Hoover's test. Journal of Neurology, 245: 797-802.</ref> The Hoover's sign is when pressure is felt the paretic leg when the non-paretic leg is raised and no pressure is felt in the non-paretic leg when the paretic leg is being raised.<ref>Kaufman, D.M. (2007). Clinical neurology for psychiatrists: 6th edition. Elsevier Health Sciences. p. 20.</ref> | ||
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== Evidence == | == Evidence == | ||
[https://physio-pedia.com/Test_Diagnostics?utm_source=physiopedia&utm_medium=search&utm_campaign=ongoing_internal#share '''Sensitivity'''] '''63%''' <ref name=":0">McWhirter, Laura, et al. "Hoover's sign for the diagnosis of functional weakness: a prospective unblinded cohort study in patients with suspected stroke." ''Journal of psychosomatic research'' 71.6 (2011): 384-386.</ref><ref name=":1">Mehndiratta MM, Kumar M, Nayak R, Garg H, Pandey S. Hoover's sign: Clinical relevance in Neurology. ''J Postgrad Med''. 2014;60(3):297-299. doi:10.4103/0022-3859.138769</ref> | |||
[https://physio-pedia.com/Test_Diagnostics?utm_source=physiopedia&utm_medium=search&utm_campaign=ongoing_internal#share '''specificity'''] '''100%'''<ref name=":0" /><ref name=":1" /> | |||
'''Hoover's sign''' was moderately sensitive and very specific for a diagnosis of functional weakness.<ref name=":0" /> | |||
== References == | == References == | ||
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Larner, A.J. (2001). A Dictionary of Neurological signs. Springer. | Larner, A.J. (2001). A Dictionary of Neurological signs. Springer. | ||
[[Category:Assessment]] [[Category:Lumbar Spine]] [[Category:Lumbar Spine - Assessment and Examination]] [[Category:Neurodynamics]] [[Category:Special_Tests]] [[Category:Neurological - Assessment and Examination]] [[Category:Musculoskeletal/Orthopaedics]] [[Category:MCG_Student_Project]] | [[Category:Assessment]] | ||
[[Category:Lumbar Spine]] | |||
[[Category:Lumbar Spine - Assessment and Examination]] | |||
[[Category:Neurodynamics]] | |||
[[Category:Special_Tests]] | |||
[[Category:Neurological - Assessment and Examination]] | |||
[[Category:Musculoskeletal/Orthopaedics]] | |||
[[Category:MCG_Student_Project]] | |||
Revision as of 19:05, 2 September 2020
Original Editor - Jee Lee and Shanae Gordon
Top Contributors - Jee Lee, Admin, Kim Jackson, Shanae Gordon, Jonathan Wong, Idris Oyewale, Rachael Lowe, Anas Mohamed, WikiSysop, Memoona Awan, Dan Rhon, Evan Thomas, Naomi O'Reilly, Rucha Gadgil and 127.0.0.1Purpose[edit | edit source]
The purpose of the test is to distinguish between leg paresis that is psychogenic from that which is genuine. Genuine leg weakness seen in paresis is considered to be "organic," and other causes of leg paresis that is not related to a neuropathological process is considered to be "nonorganic."[1]
Technique[edit | edit source]
Hoover's sign is a motor sign. It is based on the principle of crossed extensor reflex. The patient is placed in a supine/recumbent position. The examiner places his/her hand under the patient's heel. The patient is then instructed to press the heels down onto the table. The examiner is expected to feel pressure on the non-paretic limb. The patient is then asked to raise his/her non-paretic limb against downward resistance applied by the therapist. No pressure is expected to be felt under the paretic leg that is on the table.[1] The Hoover's sign is when pressure is felt the paretic leg when the non-paretic leg is raised and no pressure is felt in the non-paretic leg when the paretic leg is being raised.[2]
| [3] | [4] |
Evidence[edit | edit source]
Sensitivity 63% [5][6]
specificity 100%[5][6]
Hoover's sign was moderately sensitive and very specific for a diagnosis of functional weakness.[5]
References[edit | edit source]
- ↑ 1.0 1.1 Ziv, I., Djaldetti, R., Zoldan, J., Avraham, M., Melamed, E. (1998). Diagnosis of "non-organic" limb paresis by a novel objective motor assessment: The quantitative Hoover's test. Journal of Neurology, 245: 797-802.
- ↑ Kaufman, D.M. (2007). Clinical neurology for psychiatrists: 6th edition. Elsevier Health Sciences. p. 20.
- ↑ online video, http://www.youtube.com/watch?v=F4Fk_ZzCX6A, last accessed 6/2/2009
- ↑ Clinically Relevant Technologies, http://www.youtube.com/watch?v=QqQuPL36loM, last accessed May 2011
- ↑ 5.0 5.1 5.2 McWhirter, Laura, et al. "Hoover's sign for the diagnosis of functional weakness: a prospective unblinded cohort study in patients with suspected stroke." Journal of psychosomatic research 71.6 (2011): 384-386.
- ↑ 6.0 6.1 Mehndiratta MM, Kumar M, Nayak R, Garg H, Pandey S. Hoover's sign: Clinical relevance in Neurology. J Postgrad Med. 2014;60(3):297-299. doi:10.4103/0022-3859.138769
Koehler, P.J., Okun, M.S. (2004). Important observations prior to the description of the Hoover sign. Historical Neurology. 63: 1693-1697.
Larner, A.J. (2001). A Dictionary of Neurological signs. Springer.
