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The detection of feigned hand weakness using the five position grip strength test
M Tredgett1, L J Pimble, T R Davis
1Department of Trauma and Orthopaedics, Queen's Medical Centre, University Hospital, Nottingham, UK. amtredgett@msm.com
Journal of Hand Surgery (Edinburgh, Scotland)
|September 3, 1999
Summary
The five-position grip strength test (5PGST) is unreliable for detecting feigned hand weakness, accurately identifying it in only 15% of cases. Many participants showed normal grip strength patterns even when pretending weakness.
Area of Science:
- Neurology
- Forensic Medicine
- Occupational Health
Background:
- Hand weakness can be difficult to assess, especially when malingering is suspected.
- Objective measures are needed to differentiate genuine weakness from feigned weakness.
Purpose of the Study:
- To evaluate the diagnostic accuracy of the five-position grip strength test (5PGST) in identifying feigned hand weakness.
Main Methods:
- A study involving healthy volunteers simulating hand weakness.
- Assessment of grip strength using the five-position grip strength test (5PGST).
Main Results:
- The 5PGST demonstrated low sensitivity and specificity for detecting feigned weakness.
- Only 15% of feigned weakness cases were correctly identified by the 5PGST.
- 33% of volunteers exhibited normal grip strength patterns while feigning weakness.
Conclusions:
- The 5PGST is not a reliable tool for detecting feigned hand weakness.
- Clinical reliance on the 5PGST for identifying malingered weakness may lead to misdiagnosis.