Abstract WP115: Influence of Cognitive Factors on Motor Performance Early After Stroke
Bibliographic record
Abstract
Background: Cognitive factors influence motor performance, but often this is not considered when testing motor function. Here we examined this issue using 3 versions of the Box and Blocks Test (BBT), a measure of arm motor function. First, we developed 2 new, briefer versions of BBT and then tested their validity. Second, we hypothesized that cognitive factors would be more strongly related to versions of the BBT that require a longer period of testing. Methods: In 71 patients <=30 days post-stroke, 3 BBT versions were scored. BBT60 is the standard one; subjects move as many blocks as possible over a divider in 60 sec. We also counted # blocks moved in the first 10 sec (BBT10) and time to move the first 3 blocks (3-BBT). Other testing included 2 motor scores, Fugl Meyer (FM) and 9-Hole Peg (9HP); and 2 cognitive scores, Trail Making Test-A (TMT-A) and Montreal Cognitive Assessment (MoCA). First, we tested the validity of the briefer BBT versions (3-BBT and BBT10) against BBT60 and FM. Second, we compared all BBT versions to measures of sustained attention (TMT-A) and cognitive function (MoCA). Comparisons used Spearman’s rank correlation coefficient (threshold p<0.05). Results: Mean time post-stroke was 13.1±5.9 days; age, 66.9±14.9 yrs; 40.8% female. Median BBT scores: 3-BBT, 17.4 sec; BBT10, 2 blocks; and BBT60, 10 blocks. Other median scores: FM, 36 points, MoCA, 21 points; 9HP, 1 peg in 60 sec; TMT-A, 49.5 sec for 25 targets. Scores on 3-BBT (r=-0.93, p<0.0001) and BBT10 (r=0.95, p<0.0001) showed strong validity with BBT60 scores. Each BBT version, respectively, was related to FM score (r=-0.81, r=0.77, r=0.82; all p<0.0001) and to 9HP score (r=-0.77, r=0.82, r=0.82; all p<0.0001). TMT-A was not significantly related to 3-BBT (r=0.20, p=0.09), but was related to BBT10 (r=-0.24, p=0.04) and BBT60 (r=-0.24, p=0.04). MoCA was not significantly related to 3-BBT (r=-0.15, p=0.21) or BBT60 (r=0.20, p=0.09), but was to BBT10 (r=0.26, p=0.03). Conclusions: The 3-BBT and BBT10 are both valid measures of arm motor function in subacute stroke. Each is quicker and more easily assessed than BBT60. The BBT10 and BBT60 were more strongly related to TMT-A, and BBT60 to MoCA, suggesting that these 2 BBT versions are more influenced by attention or cognition compared to 3-BBT. All 3 BBT measures are valid; choice of which to use depends on whether the goal is to measure motor function with less (3-BBT) or more (BBT10 and BBT60) influence of attention or cognitive factors.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".