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At least 1,387 records · Page 77Linked to original sources
PubMed2000

Rapid repeat testing of grip strength for detection of faked hand weakness.

This study assessed the use of rapid, repeated measurement of grip strength to detect feigned hand weakness. Normal participants, performing with maximum effort or feigning hand weakness, and patients recovering from carpal tunnel surgery were asked to grip a Jamar dynamometer alternately with each hand on ten occasions. The results showed that grip strength fatigued by an average of 23% during the test in the normal participants, 18% in participants faking weakness, and increased by 2% in the carpal tunnel decompression patients. An increase in grip strength after the first effort was found in 39% of normal participants, 52% of participants faking hand weakness and in 69% of the carpal tunnel decompression patients. These results suggest that rapid, repeated measurement of grip strength is not a reliable discriminator of true and faked hand weakness.

Adult↗
PubMed2004

[The value of dynamic posturography (Equitest) in preparing an expert's report].

BACKGROUND: Expert appraisals of vestibular disorders and their effects on daily life are essentially based on an evaluation of the patient's subjectively described symptoms. The aim of the present study was to ascertain the extent to which dynamic posturography is able to assist in the preparation of expert's reports. MATERIAL AND METHODS: 60 patients underwent a survey of their balance impairment. Both a nystagmus analysis, with its objective criteria, and dynamic posturography were carried out. The investigation into reduction of fitness for work (MdE) made reference to the criteria specified in the table by STOLL. The data obtained were subjected to both correlation and variance analysis. RESULTS: Although the results of this analysis revealed no direct statistical dependency, they indicated a tendency for the composite values to be correlated with the nystagmus scores and/or the MdE values (when the nystagmus score and/or the MdE increases, the composite value decreases). CONCLUSIONS: The Equitest is, according to the available data, not able to replace the currently valid MdE scores. Nevertheless, it represents a means of providing objective data about the vestibulo-spinal reflex. The test also reveals any tendencies towards simulation and aggravation. In the context of a specific nystagmus analysis, the Equitest offers an additional means of providing an objective background to back up the more subjective assessment of MdE.

Adolescent↗
PubMed2005

[Simulation of deafness in expertise affairs].

The simulation of deafness rarely occurs in the course of medical expertise. However, it is a problem that needs to be recognized and demonstrated by proving methods of investigation. For this purpose, a number of subjective and objective hearing tests exist which can provide evidence for the simulation of uni- or bilateral hearing loss. These methods include the measurement of oto-acoustic emissions, brainstem-evoked response audiometry and the determination of the stapedius reflex threshold as well as subjective methods such as Stenger- and Lee-test. Among the expertise carried out in our department during the past few years, we found 5 cases of simulation of deafness. In these cases -- as opposed to simulated traffic accidents -- there was no criminal prosecution regarding insurance fraud.

Adolescent↗
PubMed1987

[The so-called "compensation neurosis"--psychopathologic syndrome or obsolete concept?].

The problems of the muddy concept of "compensation neurosis" are demonstrated under different aspects. The following fields are discussed: terminological questions, clinical picture including psychodynamic reflections and approaches as to the course, the legal bases in the Federal Republic of Germany, in particular for the legal annuity insurance and accident insurance, and the expert's problems when giving his opinion. It is suggested no longer to use the vague and inexact formulation "compensation neurosis", but a detailed description of the symptom complex and the personality as well as the outer and inner situation should be strived after. Tasks of research are mentioned that still require to be tackled.

Germany, West↗
PubMed1984

[A catamnestic follow-up of a compensation neurosis study].

The article reports on the results of a follow-up examination of 25 applicants for a social insurance pension who had been thoroughly examined 2 to 4 years earlier because of a suspicion of compensation neurosis (see Fortschritte Neurol . Psychiatr . 50 (1982) 207-214).--Two-thirds of the 24 still living persons were followed up by means of a questionnaire; in one-half of the patients, it was possible to study the court files. It was shown that comprehensive information within the framework of a psychiatric expertise which includes a personally investigated biographical anamnesis under psychological aspects of neurosis research and examination based on test psychology, usually results in rapid termination of the lawsuits involved, with mutual consent. This is a particularly interesting point, since in all cases the lawsuits instituted by the claimants had been going on for several years.

Persons with Disabilities↗
PubMed1999

[Special characteristics of expert assessment of olfactory and taste disorders].

BACKGROUND: The number of medical expert opinions dealing with smell and taste disorders has continuously increased in recent years. However, an overview of the specific problems and results of those expert opinions has not been published until now. INDIVIDUALS AND METHODS: Olfaction was assessed by multiple subjective tests in 145 individuals with chemosensory dysfunction caused by trauma or occupational and environmental exposures. Additionally, a gustatory test, nasal endoscopy, anterior rhinomanometry, and radiography of the paranasal sinuses were performed. Malignering was diagnosed on a trial of multiple symptoms. Retronasal olfaction was tested using the Güttich gustatory olfaction test. RESULTS: Most of the medical expert opinions have been ordered by professional associations (42%) and insurance companies (28%). Compensation for olfactory dysfunction was claimed after trauma (64%), occupational exposure (23%) rhinosurgical procedures (8%), and laryngectomy (5%). Anosmia or hyposmia was claimed by 66% and 24% of all individuals, respectively. According to the results of the chemosensory tests, 41% of patients suffered from anosmia and 40% had hyposmia. Malignering was registered in 14%. CONCLUSIONS: The study shows that the "characteristic case" is a male in the late fourties, complaining of anosmia initially noticed after an occipital or frontobasal head trauma. The assessment of olfactory deficits related to toxic or chemical occupational exposure is difficult when a latency between the occupational exposure and the onset of chemosensory dysfunction is present. Moreover, interactions between the occupational exposure and nicotine or alcohol abuse must be taken into consideration. Claims for medical liability arose in 3% of the study group after septoplasty and sinus surgery.

Adolescent↗
PubMed1997

[Visual field examination in limited patient cooperation].

Objective methods to estimate the visual field are necessary, if a conventional subjective perimetry is impossible due to limited cooperation. Objective methods are indicated in infants, handicapped patients, patients with psychogenic visual field loss, and malingerers. An objective estimation of the visual field can be performed by means of pupillary light reflexes, voluntary and involuntary eye movements, and visual evoked potentials. Systematically false responses contain useful information regarding the proof of misrepresentations. The reproducibility of visual field defects can be checked by testing at different distances from the screen. This article reports on handy methods requiring no large-scale equipment.

Adult↗
PubMed1980

[Visual evoked potentials in the evaluation of suspected simulation and aggravation].

Visual evoked potentials (VEP) with checkerboard stimulation are good reference for the function of the visual pathways. Normal VEP are registered from simulants and better than expected VEP are noted from aggravants. However an exact objective determination of the visual acuity is limited, due to the low correlation between retinal resolution and stimulus parameters.

Adolescent↗