Proposed classification of positive signs
| Highly reliable signs | Reliable signs | Suggestive signs |
|---|---|---|
| Giveway weakness | Spinal injury test (SIC) | Irregular drift (arm stabil.) |
| Drift without pronation | Sternocleidomastoid-test | Non digiti quinti sign |
| Co-contraction | Collapsing weakness | |
| Splitting the midline | Non-concavity of the palm | Falls always towards support |
| Splitting of vibration sense | Inconsistence of direction | Non-economic posture |
| Hoover's sign* | Mingazzini: irregular drift | Sudden knee buckling |
| Systematic failure | Tremulousness | |
| Non-anatomical sensory loss | ||
| Leg dragging | ||
| Hesitation | ||
| Psychogenic Romberg | ||
| Bizarre excursion trunk | ||
| Expressive behaviour |
Highly reliable signs defined by (1) previous validation in other samples AND (2) significant difference between groups in the current sample (Fisher p<0.05) AND (3) good to excellent inter-rater reliability (κ >0.6).
Reliable signs defined by (1) previous validation in other samples, OR (2) significant difference between groups in the current sample (Fisher p<0.05) AND (3) moderate to excellent inter-rater reliability (κ >0.4).
Suggestive signs defined by (1) high individual specificity >95% AND (2) moderate to excellent inter-rater reliability (κ >0.4).
*The Hoover sign can be considered a highly reliable sign because it fulfils all criteria, had a strong validation in several previous studies with the caveat that no inter-rater validation has been performed.