Validation of sincerity of effort.

Sincerity of subject effort is critical to the functional capacity assessment process. This review examines attempts at devising ways of objectively determining whether an evaluee performed his best during functional assessment. It is concluded that good, but not conclusive, evidence of submaximal performance can be gained in some evaluees. The 5 hand position and the rapid exchange grip tests are the best validated and most practical tests devised which can provide evidence of malingering. EMG measurements, although not as practical, may be even better. Further research is needed to further validate these tests as reliable methods of determining sincerity of subject effort.