Hoover's sign (leg paresis)
One is a maneuver aimed to separate organic from non-organic paresis of the leg. The sign relies on the principle of synergistic contraction. Involuntary extension of the "paralyzed" leg occurs when flexing the contralateral leg against resistance. It has been neglected, although it is a useful clinical test. Essentially, you hold your hand under the "weak" limb and ask the patient to flex the contralateral hip against resistance. If you feel pressure from the weak leg, the weakness is likely non organic. This is a positive Hoover's sign. If no pressure is felt, this is more likely organic limb weakness.
Strong hip muscles can make the test difficult to interpret.
Efforts have been made to use the theory behind the sign to report a quantitative result.
- "George Crile, Charles Hoover and John Phillips".
- Koehler PJ, Okun MS (November 2004). "Important observations prior to the description of the Hoover sign". Neurology 63 (9): 1693–7. PMID 15534257.
- Sonoo M (January 2004). "Abductor sign: a reliable new sign to detect unilateral non-organic paresis of the lower limb". J. Neurol. Neurosurg. Psychiatr. 75 (1): 121–5. PMC 1757483. PMID 14707320.
- Ziv I, Djaldetti R, Zoldan Y, Avraham M, Melamed E (December 1998). "Diagnosis of "non-organic" limb paresis by a novel objective motor assessment: the quantitative Hoover's test". J. Neurol. 245 (12): 797–802. doi:10.1007/s004150050289. PMID 9840352.