The Seriously Uninjured Hand???Weakness of Grip

Abstract

Loss of grip is a rateable factor in the determination of permanent disability by compensation boards in some states. Malingerers, or those with psychological rather than organic disability, can voluntarily record lower grip measurements in the so-called injured hand when compared with the normal hand. An objective method of documenting real, as opposed to fictitious, loss of grip was provided. This method utilized the sealed hydraulic dynamometer which had been adopted by some states as a standard grip measuring device. Its isometric and adjustable features were utilized to aid in the evaluation of the patient who complained of loss of grip with no objective recordable findings. The patient who voluntarily attempted to demonstrate weakness of grip applied the same minimal pressure at each adjustable handle position, producing a straight line graph. In a series of patients thought to be voluntarily applying minimal grip, there was a variance of .ltoreq. 5 lb at each handle position. An objective statement can be made that the patient did not cooperate with the test through his failure to apply maximal pressure at each dynamometer handle position as instructed.