{
  "abstract": "Background Hoover's sign is a commonly used clinical sign for diagnosing functional leg weakness, a feature of functional neurological disorder (FND). However, it relies on clinicians’ qualitative assessment. Therefore, more reliable and objective assessment methods are needed. This study aims to develop a portable device and procedure for standardized quantitative measurement of Hoover's sign and validate its utility in healthy controls feigning leg weakness. Methods Healthy volunteers without medical backgrounds were recruited. A portable floor‐based device with a pressure sensor placed under the heel of one foot was developed to measure hip extension strength during voluntary and involuntary movements. Subjects performed the test under three conditions: healthy, feigning mild weakness, and feigning severe weakness. The involuntary/voluntary ratio (IV/V ratio) and the side ratio (the IV/V ratio of the feigning leg compared to the non‐feigning leg) were evaluated. Results Forty‐two subjects were recruited. In the healthy state, the mean IV/V ratio was 0.60 ± 0.23 on the right side and 0.62 ± 0.24 on the left. The IV/V ratio was significantly higher in the feigned leg during both mild (1.26 ± 0.49) and severe (1.83 ± 0.70) feigning compared to the healthy state (p < 0.001 for both), while it was significantly lower in the non‐feigned leg during mild (0.40 ± 0.22) and severe (0.32 ± 0.22) feigning (p < 0.001 for both). The side ratio also significantly increased during feigning. ROC analysis revealed optimal IV/V ratio cutoffs of 0.93 for distinguishing mild feigning (sensitivity: 77%, specificity: 93%), and 0.95 for severe feigning (sensitivity: 91%, specificity: 94%). Conclusions This portable device can provide a standardized quantitative measure of Hoover's sign and may be useful in future studies of functional leg weakness, particularly in patients with comorbid conditions.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Neurology Teikyo University School of Medicine Itabashi‐ku Tokyo Japan",
    "School of Engineering The University of Edinburgh Edinburgh UK",
    "Centre for Clinical Brain Sciences University of Edinburgh Edinburgh UK"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Takamichi Kanbayashi"
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    {
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        1
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      "name": "Adarsh Nigam"
    },
    {
      "affs": [
        2
      ],
      "name": "Ciara Pletcher"
    },
    {
      "affs": [
        1
      ],
      "name": "Alexander White"
    },
    {
      "affs": [
        1
      ],
      "name": "Srinjoy Mitra"
    },
    {
      "affs": [
        2
      ],
      "name": "Jon Stone"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/et2xs43m272w2.bib",
  "cited_by": 0,
  "doi": "10.1002/brb3.71893",
  "fulltext_url": "https://doi.org/10.1002/brb3.71893",
  "id": "et2xs43m272w2",
  "issns": [
    "2162-3279"
  ],
  "landing_url": "https://doi.org/10.1002/brb3.71893",
  "language": "en",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
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      "Original Article"
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      "RC321-571"
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  "pdf_url": "https://europepmc.org/articles/PMC13729825?pdf=render",
  "pmcid": "PMC13729825",
  "pmid": "42975150",
  "published": "2026-11-01",
  "publisher": "Wiley",
  "ris": "https://research.draconitic.com/paper/et2xs43m272w2.ris",
  "sources": [
    {
      "first_seen": "2026-11-03T14:21:36Z",
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      "url": "https://doi.org/10.1002/brb3.71893"
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      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42975150"
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    {
      "first_seen": "2026-11-07T12:22:33Z",
      "native_id": "PMC13729825",
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      "url": "https://doi.org/10.1002/brb3.71893"
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  "subjects": [
    {
      "field": "medicine",
      "origin": "lcc:RC321-571",
      "subfield": "general"
    }
  ],
  "title": "Quantitative Measurement of Hoover's Sign: Development of a Standardized Sensor, Interface Procedure, and Testing in Healthy Individuals",
  "title_text": "Quantitative Measurement of Hoover's Sign: Development of a Standardized Sensor, Interface Procedure, and Testing in Healthy Individuals",
  "type": "peer-reviewed",
  "updated_at": "2026-11-07T12:22:33Z",
  "url": "https://research.draconitic.com/paper/et2xs43m272w2",
  "venue": "Brain and Behavior",
  "versions": []
}