The Hoover sign is a medical test named after Charles Franklin Hoover that can be used to identify true and hysterical unilateral lower extremity paresis. It consists of two parts and is performed while the patient lies supine on a plinth. The test evaluates the downward pressure of the partially paralyzed leg and the unaffected leg.
In medicine, there are two Hoover marks, both named after Ohio physician Charles Franklin Hoover. A Hoover sign refers to one lung test and the second test for true incomplete paralysis in one leg. The test for the sign consists of two parts and is performed while the patient lies supine on a plinth and the clinician, standing at the patient’s feet, places his hands under the patient’s heels. During the exam, the patient is asked to raise and lower the partially paralyzed leg and the unaffected leg while the downward pressure of the stationary leg is assessed.
A neurologist is often called to evaluate unilateral paralysis or paralysis on one side of the body. One of the conclusions a neurologist must draw during a physical exam is whether unilateral paralysis is real, partial paralysis caused by disease and tissue damage or whether the paralysis is hysterical or emotionally driven. Hoover’s sign is a tool that can be used to identify true and hysterical unilateral lower extremity paresis.
In preparation for testing for Hoover’s sign, the patient is asked to lie on an examination table on their back with their legs extended. The heels of your feet should be resting on the table with your feet at right angles to the table. Before this sign is tested, the doctor typically performs a strength test to assess the strength of the patient’s hips. This is done by asking the patient to raise and lower each leg while the examiner uses his or her hand to provide slight opposing resistance against the leg.
There are two parts to the Hoover sign test. For both parts of the test, the examiner stands at the end of the table, facing the patient’s feet, and places one hand under each heel. In the first part of the test, the patient is asked to raise the good leg while the doctor evaluates the downward pressure of the partially paralyzed leg on the palm of the hand. If the downward pressure in the doctor’s hand is equivalent to the force displayed during the strength test, then the paralysis is thought to be hysterical. When the downward force in the doctor’s hand is weaker than the test of strength, then partial paralysis is considered real or the result of a neuromuscular problem.
In the second part of the Hoover sign test, the partially paralyzed leg is elevated and the downward pressure of the sound leg in the doctor’s hand is assessed. If the downward pressure of the sound leg is less and the doctor is able to easily lift the sound leg at the same time, then partial paralysis is considered hysterical. When the downward force of the sound leg is strong, then partial paralysis is considered real.
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