원저

정상인과 Malingering 환자의 지각조절검사에서 검사-재검사의 의의

이현순1, 고의경1,*, 이일우1, 전경명1, 노환중1, 왕수건1
Hyun-Sun Lee1, Eui-Kyung Goh1,*, Il-Woo Lee1, Kyong-Myong Chon1, Hwan-Jung Roh1, Soo-Geun Wang1
Author Information & Copyright
1부산대학교 의과대학 이비인후과학교실
1Department of Otolaryngology, College of Medicine, Pusan National University, Busan, Korea
*교신저자: 고의경, 602-739 부산광역시 서구 아미동1가 부산대학교 의과대학 이비인후과학교실 전화: (051) 240-7332·전송: (051) 246-8668 E-mail: gohek@pusan.ac.kr

© Copyright 2002 The Busan, Ulsan, Gyeoungnam Branch of Korean Society of Otolaryngology-Head and Neck Surgery. This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Received: May 06, 2002; Accepted: May 31, 2002

Published Online: May 31, 2020

ABSTRACT

Background and Objectives: The clinical use of computerized dynamic posturography (CDP) in diagnosis and treatment of dizzy patient is based on its scoring system. We can assess balance disorder quantitatively with CDP and use it as a follow up test after treatment of dizziness. CDP can identify postural responses when there is suspected malingering, exaggeration of disability for compensation, or conversion disorder. So it can be used on medico-legal problem in work related claim. CDP findings of malingering show two patterns. First, there is poorer performance on sensory organization test (SOT) conditions 1, 2, 3 than on 4, 5, 6. Second, it may show excessive sway with non-overlapping tracing in MCT. To find another objective criteria for detection of malingering with CDP, we analyzed test-retest variability of SOT. Materials & Methods: Eighty healthy volunteers (forty malingerer, forty control) aged 23-31 (mean 28) were assessed by dynamic posturography. 3 cycles of SOT was done 2 weeks interval. In malingerer, the examinee was asked to pretend he or she was in the following situation. They experienced temporary unsteadiness and dizziness after job related injury. This resolved without tretment. however they are filling worker’s compensation claim for disability, and abnormal test result would strengthen their claim. Test-retest variability defined as difference maximal and minimal score of SOTs. Results: The obtained results were as follow 1) Mean scores of SOTs in malingerer lower than that of control in all 6 conditions 2) Except condition 6, test-retest variability of malingerer is significantly more than 10 compared to control (p<0.05) 3) test-retest variability of control is less than 10 in condition 1, 2, 3. 4) The most common abnormal finding of the malingerer is COG alignment (80%) Conclusion: If test-retest variability of SOT1-3 is over 10, we should strongly suspect malingering. If test-retest variability of SOT4-6 is over 10, we could suspect malingering. Thus it might be suggested that test-retest variability of SOT could detect malingering from true vertigo. (J Clinical Otolaryngol 2002;13:78-84)

Keywords: 동적자세검사; 검사-재검사 점수차
Keywords: Malingering; Sensory organization test; Dynamic posturography; Test variability