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Updated: Jun 20, 2025
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Traditional Trail Making Test Modified into Brand-new Assessment Tools: Digital and Walking Trail Making Test
Published on: November 23, 2019
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Cognitive screening test for rehabilitation using spatiotemporal data extracted from a digital trail making test
Kouki Kubo1, Seiji Hama1,2, Akira Furui3
1Department of Rehabilitation, Hibino Hospital, Hiroshima, Hiroshima, Japan.
Heliyon
|July 22, 2024
Summary
The digitized Trail Making Test (iTMT) on an iPad effectively screens cognitive function in rehabilitation patients. Its dwell time and learning effects improve estimations of cognitive abilities, aiding in patient assessment.
Area of Science:
- Neuroscience
- Rehabilitation Medicine
- Digital Health
Background:
- Brief cognitive screening tests are crucial for assessing patients in rehabilitation settings.
- The traditional Trail Making Test (TMT) is a widely used neuropsychological assessment.
- Digitizing assessments like the TMT on tablets offers potential for enhanced data collection and analysis.
Purpose of the Study:
- To evaluate a newly developed digitized Trail Making Test using an iPad (iTMT) as a brief cognitive screening tool.
- To determine if iTMT Part-A (iTMT-A) completion times, including move and dwell times, can estimate generalized cognitive function assessed by the Mini-Mental State Examination (MMSE).
- To explore the impact of repeated trials and learning effects on iTMT performance and its correlation with cognitive function.
Main Methods:
- Forty-two rehabilitation inpatients, including 30 stroke patients, performed the iTMT multiple times, alongside a paper-based TMT-A and the MMSE.
- Completion time for iTMT-A was segmented into move time and dwell time.
- Partial least squares (PLS) regression analysis was used to assess the predictive power of iTMT metrics for MMSE scores.
Main Results:
- A learning effect was observed, with faster completion times in later iTMT-A trials.
- Dwell time and move time from repeated iTMT-A, along with TMT-B availability, significantly improved the estimation of MMSE scores, even in patients with lower cognitive function.
- The dwell time component of iTMT-A emerged as a significant factor for estimating cognitive function.
Conclusions:
- The iPad-based digitized Trail Making Test (iTMT-A) shows promise as a brief cognitive screening tool for rehabilitation inpatients.
- Incorporating temporal (dwell time) and spatial elements, along with learning effects from repeated trials, enhances cognitive function estimation.
- iTMT offers a valuable method for screening both cognitive and physical functions in rehabilitation settings.
