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Simultaneous bilateral hand strength testing in a client population, Part II: Relationship to a distraction-based

James D St James1, Darrell W Schapmire, Larry Feeler

  • 1Millikin University, Decatur, IL, USA.

Work (Reading, Mass.)
|November 25, 2010
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Summary

Clients failing hand strength validity tests showed increased variability in lifting assessments, indicating abnormal test behavior rather than surgical history. This finding highlights the predictive nature of validity criteria in functional capacity evaluations.

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Area of Science:

  • Occupational Health
  • Physical Therapy
  • Rehabilitation Medicine

Background:

  • Functional Capacity Evaluations (FCEs) utilize various assessments to determine an individual's physical capabilities.
  • Validity criteria are employed to ensure the reliability of test results during FCEs.
  • Distraction-based testing involves introducing secondary tasks to assess genuine effort and performance consistency.

Purpose of the Study:

  • To investigate the relationship between performance on statistically-based validity criteria during a hand strength assessment and subsequent test behavior in a lifting assessment.
  • To determine if failing hand strength validity criteria predicts variability in lifting performance within a distraction-based FCE.

Main Methods:

  • A cohort of 200 consecutive clients undergoing FCEs participated in the study.
  • Two distraction-based testing protocols were administered: one for hand strength and another for lifting capacities.
  • Variability between repeated measures was analyzed for both assessments to evaluate test consistency.

Main Results:

  • Clients who failed two or more statistically-based hand strength validity criteria exhibited significantly greater variability in repeated measures during the lifting assessment.
  • This increased variability was statistically significant for unilateral lifts (p=0.001 for right, p=0.014 for left) and bilateral lifts (p<0.0005).
  • The findings suggest a pattern of performance related to the degree of variability in these distraction-based protocols.

Conclusions:

  • Failing hand strength validity criteria is a significant predictor of abnormal test behavior during distraction-based lifting assessments.
  • The observed pattern of performance is attributed to abnormal test behavior, not a history of surgery.
  • Both passing and failing the hand strength assessment are equally predictive of the outcome in the distraction-based lifting assessment.