title: Dynamic testing of learning potential in adults with cognitive impairments: A systematic review of methodology and predictive value.
abstract: Dynamic testing includes procedures that examine the effects of brief training on test performance where pre- to post-training change reflects patients' learning potential. The objective of this systematic review was to provide clinicians and researchers insight into the concept and methodology of dynamic testing and to explore its predictive validity in adult patients with cognitive impairments. The following electronic databases were searched: PubMed, PsychINFO, and Embase/Medline. Of 1141 potentially relevant articles, 24 studies met the inclusion criteria. The mean methodological quality score was 4.6 of 8. Eleven different dynamic tests were used. The majority of studies used dynamic versions of the Wisconsin Card Sorting Test. The training mostly consisted of a combination of performance feedback, reinforcement, expanded instruction, or strategy training. Learning potential was quantified using numerical (post-test score, difference score, gain score, regression residuals) and categorical (groups) indices. In five of six longitudinal studies, learning potential significantly predicted rehabilitation outcome. Three of four studies supported the added value of dynamic testing over conventional testing in predicting rehabilitation outcome. This review provides preliminary support that dynamic tests can provide a valuable addition to conventional tests to assess patients' abilities. Although promising, there was a large variability in methods used for dynamic testing and, therefore, it remains unclear which dynamic testing methods are most appropriate for patients with cognitive impairments. More research is warranted to further evaluate and refine dynamic testing methodology and to further elucidate its predictive validity concerning rehabilitation outcomes relative to other cognitive and functional status indices.
authors.affiliation: Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, The Netherlands.
authors.forename: Hileen
authors.initials: H
authors.lastname: Boosman
authors.affiliation: Department of Human Movement Sciences, Maastricht University, The Netherlands.
authors.forename: Thamar J H
authors.initials: TJ
authors.lastname: Bovend'Eerdt
authors.affiliation: Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, The Netherlands.
authors.forename: Johanna M A
authors.initials: JM
authors.lastname: Visser-Meily
authors.affiliation: Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, The Netherlands.|Experimental Psychology, Helmholtz Institute, Utrecht University, The Netherlands.
authors.forename: Tanja C W
authors.initials: TC
authors.lastname: Nijboer
authors.affiliation: Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience and Maastricht University, Department of Neuropsychology and Psychopharmacology, Maastricht University Medical Centre, The Netherlands.
authors.forename: Caroline M
authors.initials: CM
authors.lastname: van Heugten
mesh_terms: D000328:Adult; D003072:Cognition Disorders / Q000150:complications*; D016206:Databases, Bibliographic / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007859:Learning Disabilities / Q000175:diagnosis* / Q000209:etiology*; D008297:Male; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests
keywords: Brain Injury; Cognition; Learning; Neuropsychology; Rehabilitation; Treatment Outcome