Format

Send to

Choose Destination
J Psychosom Res. 2011 Dec;71(6):384-6. doi: 10.1016/j.jpsychores.2011.09.003. Epub 2011 Oct 6.

Hoover's sign for the diagnosis of functional weakness: a prospective unblinded cohort study in patients with suspected stroke.

Author information

1
Division of Clinical Neurosciences, Bramwell Dott Building, Western General Hospital, Edinburgh EH4 2XU, United Kingdom.

Abstract

OBJECTIVE:

Hoover's sign - weakness of voluntary hip extension with normal involuntary hip extension during contralateral hip flexion against resistance - is a commonly used sign in the diagnosis of functional weakness of the lower limb. However, little is known about the performance of this sign in clinical practice.

METHODS:

Hoover's sign was tested as part of the diagnostic work-up of 337 patients presenting to hospital with suspected stroke. We made a gold-standard diagnosis of stroke, functional disorder, or other diagnosis based on clinical history and examination, imaging and clinical follow-up. We calculated the sensitivity, specificity, positive and negative predictive values of Hoover's sign for a diagnosis of functional weakness in patients who presented with leg weakness.

RESULTS:

We consecutively recruited 337 consecutive patients with suspected stroke, 124 of whom presented with leg weakness. 8 of these patients had a diagnosis of functional disorder. The sensitivity of Hoover's sign for a diagnosis of functional weakness in those who presented with leg weakness was 63% (95% CI: 24 to 91), and the specificity was 100% (95% CI: 97 to 100).

CONCLUSIONS:

In this cohort, Hoover's sign was moderately sensitive and very specific for a diagnosis of functional weakness. Further studies are required to assess inter-observer variability and performance of the test in larger numbers of patients with functional weakness.

[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center