Motor demands of cognitive testing may artificially reduce executive function scores in individuals with spinal cord injury

Jinhyun Lee; Shauna Dudley-Javoroski; Richard K Shields

doi:10.1080/10790268.2019.1597482

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Motor demands of cognitive testing may artificially reduce executive function scores in individuals with spinal cord injury

Journal article

Open access

Peer reviewed

Motor demands of cognitive testing may artificially reduce executive function scores in individuals with spinal cord injury

Jinhyun Lee, Shauna Dudley-Javoroski and Richard K Shields

The journal of spinal cord medicine, Vol.44(2), pp.253-261

03/04/2021

DOI: 10.1080/10790268.2019.1597482

PMID: 30943119

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https://www.ncbi.nlm.nih.gov/pmc/articles/7952072View

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Abstract

Objective: To determine whether the motor demands of cognitive tests contribute to differences in cognitive function scores in participants with and without spinal cord injury (SCI). Design: Cohort study. Setting: Rehabilitation research laboratory. Participants: 68 individuals without SCI ("NON") and 22 individuals with motor complete SCI ("SCI"). Interventions: None. Outcome Measures: NIH Toolbox cognitive assessments, including two with motor demands and reaction-time based scoring (Dimensional Change Card Sort (DCCS), Flanker Inhibitory Control and Attention (Flanker) and two without timed scoring (List Sorting Working Memory (List Sorting), Picture Sequence Memory Test (Picture Sequence). Tests were administered with and without the assistance of a proctor on two randomly-determined days (>24 hr interval). For DCCS and Flanker, the motor-task score offset was estimated as the difference between the proctored and non-proctored scores. Results: For demographically-corrected data, proctoring reduced DCCS and Flanker scores (P < 0.001) but mitigated apparent differences between SCI and NON (all P > 0.403). SCI and NON did not differ for List Sorting (P > 0.072) but did differ significantly for Picture Sequence (P < 0.001). Significant practice effects existed for memory-based tests (List Sorting and Picture Sequence); all P < 0.015, effect size>0.645. Conclusions: DCCS and Flanker scores for individuals with SCI may be artificially reduced consequent to secondary motor demands of the tests. Proctoring and computation of a motor-response score offset enables comparisons to be made between individuals with SCI and a Non-SCI control cohort; however, further work is needed to determine whether offset-adjusted scores can be compared to standardized normative values.

Executive function

Spinal cord injuries

Cognition

Memory

Details

Title: Subtitle: Motor demands of cognitive testing may artificially reduce executive function scores in individuals with spinal cord injury
Creators: Jinhyun Lee - Department of Physical Therapy and Rehabilitation Science, Roy J. and Lucille A. Carver College of Medicine, University of Iowa
Shauna Dudley-Javoroski - Department of Physical Therapy and Rehabilitation Science, Roy J. and Lucille A. Carver College of Medicine, University of Iowa
Richard K Shields - Department of Physical Therapy and Rehabilitation Science, Roy J. and Lucille A. Carver College of Medicine, University of Iowa
Resource Type: Journal article
Publication Details: The journal of spinal cord medicine, Vol.44(2), pp.253-261
DOI: 10.1080/10790268.2019.1597482
PMID: 30943119
NLM abbreviation: J Spinal Cord Med
ISSN: 1079-0268
eISSN: 2045-7723
Publisher: Taylor & Francis
Grant note: DOI: 10.13039/100006937, name: National Center for Medical Rehabilitation Research, award: R01 HD082109, R01 HD084645
Language: English
Date published: 03/04/2021
Academic Unit: Orthopedics and Rehabilitation; Physical Therapy and Rehabilitation Science
Record Identifier: 9984046830602771

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