Table 2.

Special Tests for Myelopathy That May Be Performed in a Telemedicine Visit.

Test	Description	Positive result	Able to be performed in the telemedicine setting?
Hoffman sign	With long finger proximal interphalangeal joints in full extension flexion/snapping of distal interphalangeal	Flexion of thumb and index interphalangeal joints	No
Reflex exam	Reflex hammer evaluation of myotendinous reflex arcs	Hyperreflexia suggestive of long tract findings	No
Inverted Brachioradial reflex	Tapping distal brachioradialis tendon	Ipsilateral finger flexion (supinator reflex)	No
Finger escape sign	Fingers held in adducted and extended position for 30 seconds	Ulnar drift and flexion of ring and small fingers	Yes
Grasp and release test	Beginning with an open palm, the patient is instructed to grip and release their fingers as many times as possible within a period of 10 seconds.	Inability to complete 20 repetitions within 10 seconds suggestive of underlying myelopathy	Yes
10-second step test	In standing position, patient “marches” in place, taking alternating high steps raising hips to 90° of flexion. Number of alternating steps in 10 seconds recorded	Inability to take 20 total steps within 10 seconds suggestive on underlying myelopathy	Yes