Detection of grip sincerity, Hong Kong data

Dasari, B.D. and Leung, K.F. (2002) Detection of grip sincerity, Hong Kong data. Occupational Therapy Symposium, Hong Kong. 19 Jan 2002.

Abstract

Grip function is one of the many components to be considered in the overall assessment of hand function. It is well known that a standardized grip strength assessment can provide clinicians with quantifiable and objective information about their clients. There has been increasing demand for therapists to conduct functional evaluation for claims related to employee compensation or personal injury litigations. Since functional hand evaluation is a kind of performance test, its validity relies heavily on the cooperation or sincerity of the subjects being assessed. Further more, with the increasing need for reliable medical documentation, it is important that we obtain an objective and sincere measurement of the grip test. Although several researchers had made attempts to detect malingering of effort in grip strength measurements, to date there are no substantative studies to show clearly the difference between sincere and fake effort when conducting grip measurement tests. The study of this nature has great potential to develop a more accurate method to detect the sincerity of effort.
The study was conducted on both healthy people and people recovered from various hand injuries. The study sample consisted a total of 80 experimental (patients) group and a total of 40 healthy (control) group based on the strict selection criteria. Each group of subjects was tested in a series of maximal sustain grip power test of both hands with the Jamar dynamometer of the EVAL System (Green Leaf) by following a standardized test procedure. All the subjects were tested during two sessions while performing both fake and sincere effort. The series of test procedure produced 2 sets of sincere grip test results, i.e. injured hand and unaffected hand for each subject.
The EVAL system software was used to capture the data. Based on this study, force-time curves of each trial were analyzed for peak and average forces and force variability. The frequency distribution of the sincere values for each of these variables was used to determine a criterion value for discrimination of sincere and fake trials. Based on the peak force, average force (over 3 trials) and the variability of the plateau region of each force-time curve, five discriminator variables (D1-D5) were calculated. They were then tested for prediction accuracy in discriminating between sincere and fake effort
Factors and rationale influencing results and the implication of this study on current practice will be discussed.

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