BACKGROUND: Distraction based material handling tests are used to measure effort during functional capacity evaluations.
OBJECTIVE: To identify validity of effort using the under loading method with the XRTS Lever Arm. Classification of effort between the two sessions (100% effort and estimated 50% effort) was compared with current validity criteria.
METHODS: Fifty healthy and asymptomatic subjects were tested under two conditions (100% effort and an estimated 50% effort). Comparisons were made between percent changes from crate lifts to lever arm lifts from three starting heights (0.25 m, 0.38 m and 0.051 m).
RESULTS: During the 100% effort sessions, no subject had a mean percent change >20%, a majority of lift comparison >25% or a single lift comparison >30%. The specificity of the current validity criteria is 100%. The under loading method of using the XRTS lever arm was 20% sensitive in identifying an equivocal or invalid test result when subjects gave an estimated 50% effort.
CONCLUSIONS: The results indicate the under loading method of distraction based testing is very specific but lacks sensitivity in identifying feigned weakness with asymptomatic, non-injured individuals. The high specificity of the test should eliminate concern of having a false positive for insincere effort during functional testing.
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