Category: Cross-Cutting; Measurement
Objective : To identify distinct motor function profiles among persons with spinal cord injury (SCI), traumatic brain injury (TBI), and stroke.
Design : Cross-sectional study.
Setting : Three U.S. rehabilitation facilities.
Participants (or Animals, Specimens, Cadavers) : Volunteer sample of community-dwelling adults with medically-documented SCI (n=209), TBI (n=184), or stroke (n=211).
Interventions : Not applicable.
Main Outcome Measure(s) : Participants completed the Motor Battery (MB) of the NIH Toolbox for the Assessment of Neurological and Behavioral Function. Analysis focused on MB assessments of dexterity, endurance, balance, and strength.
Results : Latent profile analysis identified four motor function profiles. Relative to the full sample, 1) the low function group (n=53, 10.0%) had the lowest scores across domains, 2) the average group (n=220, 41.5%) had average scores across domains, 3) the high function group (n=131, 24.7%) had the highest scores across domains, and 4) the upper extremity function group (n=126, 23.8%) had balance and endurance scores comparable to the low function group, and dexterity and grip scores comparable to the high function group. Logistic regression demonstrated that, relative to those in the high function group, 1) those in the low function and upper extremity function groups were more likely to have a diagnosis of SCI than stroke (OR=9.97 and 13.04) or TBI (OR=167.70 and 187.05), and to have a diagnosis of stroke than TBI (OR=5.38 and 8.33), and 2) those in the average group were more likely to have a diagnosis of SCI (OR=5.35) or stroke (OR=3.57) than TBI.
Conclusions : Four motor function profiles, distinguishable by diagnosis, were identified among individuals with neurologic disorders, supporting the construct validity of the NIH Toolbox MB. Future research should examine whether distinct profiles are stable over time, and whether tailored rehabilitation interventions can alter profile membership.
Rina Fox– Research Assistant Professor, Northwestern University Feinberg School of Medicine, Chicago, Illinois
Noelle Carlozzi– Associate Professor, University of Michigan, Ann Arbor, Michigan
Allen Heinemann– Professor, Physical Medicine and Rehabilitation, Northwestern University, Chicago, Illinois
David Tulsky– Professor, University of Delaware, Newark, Delaware
Richard Gershon– Professor, Northwestern University Feinberg School of Medicine, Chicago, Illinois