Hoovers Sign (Neurological)
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The purpose of the test is to differentiate between leg paresis that has no definitive neurological pathology (non-organic) to that which has a definite, identifiable cause (organic).[1]This test was first described by Dr Charles Franklin Hoover in 1908 as a bedside test to identify functional weakness in the lower extremities.[2]
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.[3]
| [4] | [5] |
Evidence[edit | edit source]
Sensitivity 63% [6][7]
specificity 100%[6][7]
Hoover's sign was moderately sensitive and very specific for a diagnosis of functional weakness.[6]
References[edit | edit source]
- 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.
- ↑ 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.
- ↑ Shams T, Ashraf F, DeGeorgia M. Charles Franklin Hoover and the Hoover Sign (P04. 006). Neurology Apr 2012 78:1
- ↑ 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
- ↑ 6.0 6.1 6.2 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.
- ↑ 7.0 7.1 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
