Clinical application of the DEC variables in assessing maximality of muscular effort: report of 34 patients.

Abstract

To examine maximality of muscular effort in patients with expected muscle strength deficiency using acceptance-rejection cutoff values derived from isokinetic testing of maximal and feigned effort in normal subjects. A retrospective study of 34 patients with orthopedic, rheumatic, or neurologic disorders for which financial compensation was sought. The relevant scores in all patients save one were less than the respective cutoff values that in normal subjects differentiate maximal effort (below cutoff) from feigned weakness (above cutoff) at a 95% level of confidence. If normal subjects-based cutoff values are accepted as benchmarks for validation of muscle strength deficiency claims, this study indicates that subject to a given protocol, patients performed at a maximal level of effort.