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Related Experiment Videos

The "make/break test" as a diagnostic tool in functional weakness.

R J van der Ploeg1, H J Oosterhuis

  • 1Department of Neurology, University Hospital Groningen, The Netherlands.

Journal of Neurology, Neurosurgery, and Psychiatry
|March 1, 1991
PubMed
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This study differentiates functional weakness from organic weakness using dynamometer strength testing. Patients with functional weakness showed greater strength gains with encouragement and less fatigue.

Area of Science:

  • Neurology
  • Physical Medicine & Rehabilitation
  • Biomedical Engineering

Background:

  • Muscle strength assessment is crucial for diagnosing neurological and musculoskeletal disorders.
  • Differentiating between organic (tissue-based) and functional (non-organic) weakness can be challenging.
  • Objective measures are needed to support clinical evaluation of muscle strength.

Purpose of the Study:

  • To investigate objective methods for distinguishing functional muscle weakness from organic weakness.
  • To evaluate the utility of dynamometry, encouragement, and fatiguability testing in this differentiation.
  • To identify specific strength testing parameters indicative of functional weakness.

Main Methods:

  • Muscle strength was quantified in four major muscle groups using a hand-held dynamometer.

Related Experiment Videos

  • The "make" (concentric) and "break" (eccentric) contraction techniques were employed.
  • Strength testing was performed with and without verbal encouragement.
  • Fatiguability was assessed in patients with diagnosed organic weakness and functional weakness.

    • Main Results:

    • Patients with functional weakness demonstrated a significant increase in strength (>20%) using the "break" technique compared to the "make" technique.
    • Individuals with functional weakness exhibited greater strength improvements when provided with encouragement.
    • Reduced fatiguability was observed in the functional weakness group compared to the organic weakness group.

    Conclusions:

    • Hand-held dynamometry, particularly the "break" vs. "make" technique comparison, can help differentiate functional weakness.
    • Encouragement and fatiguability testing provide supplementary objective data for diagnosing functional weakness.
    • These objective findings support the clinical identification of functional neurological disorder affecting motor function.