Simple quantitative analysis of Hoover's test in patients with psychogenic and organic limb pareses

ObjectivesTo perform a quantitative evaluation of Hoover's test using a simple device — routine weighing scales. To determine a cut-off value of a Hoover's index, and to analyze the behavior of Hoover's test in “painful paresis”.MethodsThe subjects were 9 patients presenting with psychogenic paresis of one leg, 9 with organic paresis (after stroke), 9 with lumbar back and leg pain (lumbar radiculopathy), and 9 healthy controls. The following parameters were measured: the ratio between voluntary/involuntary pressure force of each leg [Hoover's index (HI)], the ratio between HI in the affected and non-affected leg [Side index (SI)].ResultsPatients with psychogenic paresis had a significant increase in the HI in the affected leg and SI, compared to the other three groups. We suggest a cut-off of a Hoover's index of 1.4 as a cut-off value for future research studies. In our study we obtained a specificity and sensitivity of 100% (with 66.4–99.7 confidence interval).ConclusionOur study suggests that the quantitative analysis of the Hoover's test can be simple, reliable and cheap method of differential diagnosis between psychogenic and organic pareses, which could be of value in the routine neurological practice.