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The abstract for
our initial study appears below. The full article has been published in the
Journal of Hand Therapy, Volume 15, Number 3, July-September 2002, pgs.
242-250.
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Simultaneous Bilateral Testing: Validation of a New
Protocol to Detect Insincere Effort During Grip and Pinch Strength
Testing
Darrell Schapmire, MS, Industrial Rehabilitation Consultants, Hopedale,
IL; James D. St. James, PhD, Department of Behavioral Sciences, Millikin
University, Decatur, IL; Rob Townsend, MS, Work Conditioning Systems,
Palos Heights, IL; Tom Stewart, PT, Allegheny and Chesapeake Physical
Therapists, Ebensburg, PA; Steven Delheimer, MD (Neurosurgeon), Peru, IL;
Dan Focht, OT, MA, Tri-State Occupational Health, Dubuque, IA
ABSTRACT
The detection of feigned weakness in hand-grip strength assessment is
difficult. We review several proposed methods and their weaknesses. A
comparison of unilateral testing and simultaneous bilateral testing with
the Jamar™ dynamometer and the Baseline™ pinch gauge is demonstrated as a
solution. An experiment employed 100 asymptomatic subjects tested twice,
once under instructions to give a full effort and once under instructions
to feign weakness. Seven statistical criteria of noncompliance were
chosen. Defining noncompliance as failing two or more of the seven
criteria, 99% of the instructed-noncompliant subjects were correctly
classified as noncompliant. No subjects were incorrectly classified as
noncompliant during instructed compliant testing. Twelve subjects failed a
single criterion. On retesting, all but one were correctly classified. One
subject in the instructed-noncompliant group passed all criteria.
Including retesting of the 12 "grey-zone" subjects, accuracy was 99.5%. |
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