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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.

 

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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