Reliable serial measurement of cognitive processes in rehabilitation: the Cognitive Log.
OBJECTIVE
To evaluate the reliability and utility of a brief quantitative measure of cognitive recovery, the Cognitive Log (Cog-Log), developed for daily use with rehabilitation inpatients to provide information about the recovery of higher neurocognitive processes including verbal recall, attention, working memory, motor sequencing, and response inhibition.


METHODS
Descriptive study of the Cog-Log's normative scores, reliability (interrater, internal consistency), and validity as shown by its relationship to standard neuropsychologic measures.


METHODS
Inpatient rehabilitation hospital affiliated with a large university medical center.


METHODS
One hundred fifty neurorehabilitation inpatients with acquired brain injury; 83 young adults without acquired brain injury were included to provide normative data.


METHODS
Not applicable.


METHODS
The Cog-Log; standardized neuropsychologic measures of memory (Wechsler Memory Scale-Revised, Rey Auditory Verbal Learning Test), language, attention (Wechsler Adult Intelligence Scale-Revised), and reasoning (Trail Making Test).


RESULTS
Reliability analysis showed strong interrater reliability across items (Spearman r, .749-1.00) and high internal consistency (Cronbach alpha=.778). Factor analysis of the Cog-Log using principal components extraction revealed a unitary factor (eigenvalue=3.48). Cog-Log items designed to measure working memory and immediate and delayed verbal memory were most strongly predictive of performance on similar standardized neuropsychologic measures administered on the same day.


CONCLUSIONS
The Cog-Log appears to be a reliable and efficient tool for measuring ongoing neurocognitive recovery during inpatient rehabilitation.
Department of Physical Medicine and Rehabilitation, University of Alabama, Birmingham, USA. amy_alderson@shepherd.org
Amy L
AL
Alderson
Thomas A
TA
Novack
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001930:Brain Injuries / Q000150:complications*; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology / Q000534:rehabilitation; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009048:Motor Skills; D009483:Neuropsychological Tests / Q000592:standards*; D015588:Observer Variation; D009949:Orientation; D011594:Psychometrics; D012044:Regression Analysis; D012680:Sensitivity and Specificity