Sincerity of Effort & Symptom Validity Flashcards
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The coefficient of variation (CV) threshold most commonly used in grip strength testing to indicate consistent, reliable effort is:
Answer: Less than 15%
A CV of less than 15% across repeated grip strength trials is the widely accepted criterion indicating consistent, sincere effort.
In the five-position grip strength test, a bell-shaped curve of results (low-high-low pattern) across positions 1 through 5 is considered a sign of:
Answer: Sincerity of maximal effort
A bell-shaped curve where grip strength peaks at position 2 or 3 and tapers at the extremes is the normal pattern indicating sincere maximal effort.
The Rapid Exchange Grip (REG) test is used in FCE primarily to:
Answer: Detect submaximal effort by comparing REG to sustained grip values
The REG test compares rapid-alternating grip values to sustained grip; submaximal effort is suggested when REG values are unexpectedly higher than sustained grip values.
Waddell's non-organic signs are used in FCE to assess:
Answer: Behavioral indicators that may suggest symptom magnification
Waddell's signs are behavioral and physical exam findings that may indicate non-organic contributions to pain and disability, signaling possible symptom magnification.
Which of the following is the MOST appropriate term for a clinical finding when an examinee performs below their actual physical ability during FCE testing?
Answer: Submaximal effort
Submaximal effort is the clinically appropriate, objective term; malingering implies intent to deceive, which FCE evaluators cannot definitively determine.
Heart rate monitoring during FCE testing is used as a sincerity of effort indicator because:
Answer: Submaximal effort typically produces a disproportionately low heart rate relative to reported exertion
When an examinee reports maximal effort and severe pain yet demonstrates a low cardiovascular response, this physiological inconsistency suggests submaximal effort.
Which consistency criterion indicates reliable performance during range-of-motion testing in an FCE?
Answer: All three repeated measurements within 5 degrees of each other
ROM reliability is typically established when three repeated measurements fall within 5 degrees of each other, demonstrating consistent, reproducible effort.