Hoover’s sign of leg paresis is one of two signs named for Charles Franklin Hoover.[1]
One is a maneuver aimed to separate organic from non-organic paresis of the leg.[2] 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.[3]
Efforts have been made to use the theory behind the sign to report a quantitative result.[4]
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