Hoover’s sign of leg paresis is one of two signs named for Charles Franklin Hoover

Charles Franklin Hoover

Charles Franklin Hoover was an American physician born in Cleveland, Ohio, who read medicine at Harvard. He worked in Vienna under Neusser, and in Strasbourg with F Kraus before returning to Cleveland. He was appointed Professor of Medicine in 1907...

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One is a maneuver aimed to separate organic from non-organic paresis

Paresis

Paresis is a condition typified by partial loss of voluntary movement or by impaired movement. When used without qualifiers, it usually refers to the limbs, but it also can be used to describe the muscles of the eyes , the stomach , and also the vocal cords...

 of the leg. 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 contralateral heel and ask the patient to extend the leg off the bed

Bed

A bed is a large piece of furniture used as a place to sleep, relax, or engage in sexual relations.Most modern beds consist of a mattress on a bed frame, with the mattress resting either on a solid base, often wooden slats, or a sprung base...

. If you feel pressure from the contralateral heel, the weakness is likely organic. If no pressure is felt, the patient is likely suffering from non-organic limb weakness.

Strong hip muscles can make the test difficult to interpret.

Efforts have been made to use the theory behind the sign to report a quantitative result.