Hoovers sign for the diagnosis of functional weakness: A prospective unblinded cohort study in patients with suspected stroke

Journal of Psychosomatic Research, 10/11/2011

In this cohort, Hoover's sign was moderately sensitive and very specific for a diagnosis of functional weakness.


  • Hoover's sign was tested as part of the diagnostic work–up of 337 patients presenting to hospital with suspected stroke.
  • The authors made a gold–standard diagnosis of stroke, functional disorder, or other diagnosis based on clinical history and examination, imaging and clinical follow–up.
  • The authors 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.


  • The authors 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).

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