[3] The Hoffmann's reflex test itself involves loosely holding the middle finger and flicking the fingernail downward, allowing the middle finger to flick upward reflexively.
A positive Hoffmann's reflex and finger jerks suggest hypertonia, but can occur in healthy individuals, and are not useful signs in isolation.
A positive Hoffmann's sign in the normal patients is more commonly found in those who are naturally hyper-reflexive (e.g. 3+ reflexes).
A positive Hoffmann's sign is a worrisome finding of a disease process if its presence is asymmetrical, or has an acute onset.
This fact has led some neurologists to reject strongly any analogies between the finger flexor reflex and the plantar response.