Article

Cross-sectional design. OBJECTIVES: To investigate whether the Fly
Test can be used to differentiate patients with whiplash-associated disorders
(WAD) from asymptomatic persons who deliberately feign symptoms and from WAD
patients exaggerating symptoms. The lack of valid clinical tests
makes it difficult to detect a justifiable cause for compensation claims in
traumatic neck-pain disorders. METHODS: The Fly Test recorded the accuracy of
neck movements in patients with WAD (n = 34) and asymptomatic persons (n = 31).
The participants followed a moving "Fly" on a computer screen with a cursor from
sensors mounted on the head. Two conditions were tested, sincere versus feigned
efforts. In the former, the participants moved their neck as accurately as
possible. In the latter, a short text was presented describing a fictitious
accident (asymptomatic group) or imagining more intense pain/suffering (WAD
group), and the test was performed as affected by these more serious conditions.
Amplitude accuracy (AA), time on target (ToT) and jerk index (JI) were compared
across patterns, conditions and groups. RESULTS: The sincere effort in the WAD
group was significant compared to the feigned effort of the asymptomatic group (p
< 0.001). For AA, correct categorization of 81.5% of the performances was made,
where a mean score above 5.5 mm differentiated feigned versus sincere efforts in
asymptomatic and WAD groups (sensitivity 79.4%, specificity 67.7%). For ToT,
score above 11% indicated correctly categorized WAD patients (sensitivity 82.4%,
specificity 64.5%). CONCLUSION: The Fly Test can provide clinicians a clue when
patients with mild to moderate pain/disability are feigning or exaggerating
symptoms.

Langue : ANGLAIS