Simultaneous bilateral hand strength testing in a client
population, Part I: Diagnostic, observational and subjective complaint
correlates to consistency of effort
Affiliations: X-RTS Software Products, Inc., Hopedale, IL, USA | Millikin University, Decatur, IL, USA | WorkSTEPS, Inc., Austin, TX, USA | Joseph A. Kleinkort, PC, Trophy Club, TX, USA
Note: [] Address for correspondence: Darrell Schapmire, MS, X-RTS
Software Products, Inc., P.O. Box 171, Hopedale, IL 61747, USA. Tel.: +1 309
449 5483; E-mail: [email protected]
Abstract: Objectives: 1. To determine if scores on pain questionnaires and
overt behaviors during a functional capacity evaluation (FCE) were related to
variability between repeated measures during a hand strength assessment. 2. To
determine if failure of statistically-based validity criteria, as proposed by
Schapmire, St. James and Townsend et al. [26] is likely to be due to
pain. Participants: 200 consecutive clients presenting for an FCE. Methods: Subjects filled out pain questionnaires, were observed for various
behaviors and were administered the distraction-based hand strength assessment. Results: Clients failing two or more of the statistically-based validity
criteria had higher scores on most pain questionnaires, presented with a higher
frequency of various pain behaviors (p < 0.05 and < 0.001,
respectively), and had a lower rate of relevant surgeries (p < 0.001).
There was no statistically significant difference in the number of failed
validity criteria between this group of clients and for normal subjects
feigning weakness in a controlled study (p> 0.05). Conclusions: Pain does not reasonably explain the failure of the statistically-based validity
criteria. The protocol is appropriate for use in a client population.
Keywords: Distraction-based testing, validity of effort, functional capacity evaluation (FCE) Sincerity of effort
