Pavol Marykay A, Stein Joel, Kabir Foyruz M, Yip Jonathan, Sorkin Lyssa Y, Marshall Randolph S, Lazar Ronald M
Stroke Division, Department of Neurology, Columbia University College of Physicians & Surgeons, New York, NY, USA.
Department of Rehabilitation and Regenerative Medicine, Columbia University College of Physicians & Surgeons, New York, NY, USA.
Rehabil Res Pract. 2017;2017:4516219. doi: 10.1155/2017/4516219. Epub 2017 Apr 27.
The ability of neuropsychological tests to predict rehabilitation outcome is unclear, particularly when other ratings of cognition are available. Neuropsychological test scores and functional ratings of cognition (Functional Independence Measure (FIM) Cognition score) were used to predict improvement in patient mobility and self-care skill, as measured by the FIM Motor score. Regression models used both raw neuropsychology test scores and age-adjusted scores. Retrospective chart review was performed for patients on an inpatient rehabilitation unit and referred for neuropsychological assessment. The group included 126 subjects (average age 64.2 ± 17.1 years) and a variety of medical diagnoses. Neuropsychological tests included the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). After forcing the Admission FIM Cognition score into the model, RBANS scores and duration of rehabilitation predicted FIM Motor improvements ( = 11.42, < 0.0001). Raw neuropsychological test scores performed better than the model with age-adjusted test scores. FIM Cognition alone did not predict FIM Motor improvements. Neuropsychological tests, combined with duration of rehabilitation, predicted mobility gains for patients undergoing inpatient rehabilitation beyond what was predicted by another, readily available, assessment of cognition. Neuropsychology raw scores performed better than age-adjusted scores, raising questions about the standard use of demographic adjustments for predicting real-world function.
神经心理学测试预测康复结果的能力尚不清楚，尤其是当有其他认知评分可用时。神经心理学测试分数和认知功能评分（功能独立性测量（FIM）认知分数）被用于预测患者运动能力和自我护理技能的改善情况，这通过FIM运动分数来衡量。回归模型使用了神经心理学测试的原始分数和年龄调整分数。对住院康复单元中接受神经心理学评估的患者进行了回顾性病历审查。该组包括126名受试者（平均年龄64.2±17.1岁），有多种医学诊断。神经心理学测试包括可重复神经心理状态评估量表（RBANS）。在将入院时的FIM认知分数纳入模型后，RBANS分数和康复时长预测了FIM运动能力的改善（ = 11.42， < 0.0001）。神经心理学测试的原始分数比年龄调整分数模型表现更好。仅FIM认知分数并不能预测FIM运动能力的改善。神经心理学测试与康复时长相结合，能够预测住院康复患者的运动能力提升，其预测效果超过了另一种现成的认知评估方法。神经心理学原始分数比年龄调整分数表现更好，这引发了关于在预测实际功能时使用人口统计学调整的标准做法的质疑。
