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Cognitive Processing Speed Impairment Does Not Influence the Construct Validity of Six-Spot Step Test Performance in
Brian M Sandroff1,2, Stephanie L Silveira1, Jessica F Baird1
1University of Alabama at Birmingham, Department of Physical Therapy, Birmingham, Alabama, USA.
Physical Therapy
|December 29, 2020
Summary
Cognitive processing speed impairment does not invalidate the Six-Spot Step Test (SSST) as a functional mobility measure in multiple sclerosis (MS). The SSST remains a precise tool for assessing walking function in people with MS, irrespective of cognitive status.
Area of Science:
- Neurology
- Rehabilitation Science
- Clinical Assessment
Background:
- The Six-Spot Step Test (SSST) is a validated measure of functional mobility in multiple sclerosis (MS).
- Cognitive processing speed deficits are common in MS and may impact performance on complex motor tasks.
- The influence of cognitive processing speed impairment on the SSST's validity in MS is not well understood.
Purpose of the Study:
- To investigate whether cognitive processing speed impairment affects the construct validity and precision of the SSST as a functional mobility measure in individuals with MS.
- To determine if cognitive deficits confound SSST performance interpretation in MS.
Main Methods:
- A cohort of 213 participants with MS completed the SSST and various other mobility and cognitive assessments, including the Symbol-Digit Modalities Test (SDMT) for cognitive processing speed.
- Participants were categorized into subgroups based on SDMT performance (impaired vs. unimpaired cognitive processing speed).
- Correlations between SSST performance and other mobility measures were analyzed within the overall sample and subgroups, and differences in precision for differentiating walking function were compared.
Main Results:
- SSST performance demonstrated significant and strong correlations with most other mobility outcomes across all participants and subgroups.
- The strength of correlations between SSST and other mobility measures did not significantly differ between participants with and without cognitive processing speed impairment.
- Cognitive processing speed impairment did not reduce the SSST's ability to precisely differentiate levels of walking function in MS.
Conclusions:
- Cognitive processing speed impairment does not invalidate or reduce the precision of the SSST when used as a functional mobility measure in people with MS.
- The SSST is a reliable and high-quality outcome measure for research and clinical practice in MS, suitable for individuals with or without cognitive processing speed deficits.
- This finding is crucial for MS rehabilitation, given the frequent co-occurrence of mobility and cognitive impairments.
