Assessing Functional Leg Weakness

When patients present with functional symptoms. It can be difficult to discern whether if it is an actual or functional weakness. And it can be even more difficult to convince the patient. However these tests can not only help you workout what is happening, but also demonstrate function to the patient.Both of these tests are for functional leg weakness.

Hoover’s Test

  1. Establish that patient is unable to push “WEAK” thigh down (i.e. extend hip)
  2. Place one hand on top of “NORMAL” thigh, and one under the “WEAK” thigh
  3. Ask the patient to push “NORMAL” thigh up against your hand
  4. If it is functional the patient will unintentionally tense the “WEAK” hamstrings and resist you pushing your hand down on the “WEAK” side

Abductor Test

  1. Establish that patient is unable to push “WEAK” thigh out(i.e. abduct hip)
  2. Place one hand on the lateral side of “NORMAL” thigh, and one on lateral side of “WEAK” thigh
  3. Ask the patient to push “NORMAL” thigh out against your hand
  4. If it is functional the patient will unintentionally tense the “WEAK” abductors and resist you pushing your hand inward on the “WEAK” side

 

BMJ article on functional disorders – [HERE] has other tests

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