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

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 ...