{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T03:23:18Z","timestamp":1776914598546,"version":"3.51.2"},"reference-count":12,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,11,15]],"date-time":"2023-11-15T00:00:00Z","timestamp":1700006400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disord Clin Pract"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The demonstration of positive signs during neurological examination is a cornerstone of the diagnosis of functional movement disorders, however, the available data supporting the diagnostic value of some of these signs is limited.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To determine the diagnostic value (sensitivity and specificity) of the \u201cwhack\u2010a\u2010mole\u201d (WAM) and \u201cswivel chair\u201d (SC) tests in patients with functional movement disorders (FMD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We enrolled patients with functional and organic movements in the WAM test if they exhibited tremor, dystonia, myoclonus, chorea, or tics. For the SC test, patients with a gait disorder as their primary impairment were recruited. Two blinded movement disorder specialists rated the presence of these signs in edited videos.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Inclusion criteria were met by 42 patients with FMD and 65 patients with organic movement disorders. Both tests demonstrated high specificity (means, 78% and 96%), but their sensitivity was low (means, 52% and 37%). Interobserver agreement for the WAM sign was 0.77 in the FMD group, against 0.28 in patients with organic movement disorders, whereas for the SC sign was 0.69 in both groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The present study indicates that physicians must be cautious in the application and interpretation of these clinical signs in the diagnosis of functional movement disorders, and they should be carefully considered and used as necessary.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mdc3.13895","type":"journal-article","created":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T07:28:07Z","timestamp":1695972487000},"page":"63-68","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["A Critical Appraisal of the <scp>Whack\u2010a\u2010Mole<\/scp> and Swivel Chair Signs in the Diagnosis of Functional Movement Disorders"],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4967-866X","authenticated-orcid":false,"given":"Tjerk J.","family":"Lagrand","sequence":"first","affiliation":[{"name":"Department of Neurology Alrijne Ziekenhuis  Leiderdorp The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marjolein","family":"Brusse\u2010Keizer","sequence":"additional","affiliation":[{"name":"Health Technology and Services Research, Faculty of Behavioural, Management and Social Sciences, Technical Medical Centre University of Twente  Enschede The Netherlands"},{"name":"Medical School Twente, Medisch Spectrum Twente  Enschede The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Charmley","sequence":"additional","affiliation":[{"name":"Department of Neurology Townsville University Hospital  Douglas Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark J.","family":"Edwards","sequence":"additional","affiliation":[{"name":"Institute of Psychiatry, Psychology and Neuroscience, King's College London  London United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5783-571X","authenticated-orcid":false,"given":"Marina A.J.","family":"Tijssen","sequence":"additional","affiliation":[{"name":"Department of Neurology University Medical Center Groningen, University of Groningen  Groningen The Netherlands"},{"name":"Expertise Center Movement Disorders Groningen University Medical Center Groningen  Groningen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander C.","family":"Lehn","sequence":"additional","affiliation":[{"name":"Department of Neurology Princess Alexandra Hospital  Brisbane Queensland Australia"},{"name":"University of Queensland  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,11,15]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.4997\/JRCPE.2011.110"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2012-304607"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2013-307381"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/mdc3.12177"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1092852920001996"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-030-86495-8"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.nrl.0000256358.52613.cc"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.20650"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.22340"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2003.09.005"}],"container-title":["Movement 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Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mdc3.13895","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T10:19:45Z","timestamp":1760955585000},"score":1,"resource":{"primary":{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/10.1002\/mdc3.13895"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,15]]},"references-count":12,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,1]]}},"alternative-id":["10.1002\/mdc3.13895"],"URL":"https:\/\/doi.org\/10.1002\/mdc3.13895","archive":["Portico"],"relation":{},"ISSN":["2330-1619","2330-1619"],"issn-type":[{"value":"2330-1619","type":"print"},{"value":"2330-1619","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,15]]},"assertion":[{"value":"2023-06-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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