Performing cognitive tasks during walking unmasks developing dementia by increasing gait variability, however, the analysis requires costly equipment. Fine motor activities are represented by larger brain areas than leg movement. This might open the way for broad use of dual tasking as psychological diagnostic tool. In 2012 we validated the 20 Cents Test as an instrument to asses fine motor function. Ergotherapists examined 205 patients (age 60-96, a third of who were cognitively declined) concerning their fine motor skills. Blinded physiotherapists measured the time needed to pick up 20 one-cent coins (European and US currency) and transport them into a box. 189 patients repeated the test with the same and another therapist. We found good validity (AUC>0.8), intra- and interrater reliability (ICC>0.9). Thus we defined standard values that we plan to use to establish a dual task procedure with a subtest of verbal fluency from the CERAD battery. The effect of simultaneous cognitive testing on the result of the 20 Cents Test will be analyzed in correlation to the presence of cognitive impairment. The data we will present could introduce it as a suitable partner for dual tasking to detect early stages of cognitive decline.

During the past decade, the focus of rehabilitation medicine has shifted to occupational performance and participation in different life roles. The Functional Loewenstein Occupational Therapy Cognitive Assessment (FLOTCA) was developed to assess integrative higher cognitive abilities, and it was validated on a Traumatic Brain Injury (TBI) population. The FLOTCA consists of 3 tasks: navigating on a map, organizing a tool box and planning a daily schedule. In this first study, participants included 25 TBI patients, ages 18-49 and a matched group of 25 healthy individuals. Both groups were assessed with the FIM/FAM a daily functional evaluation. The FLOTCA showed high inter rater reliability (ICC= .996), internal consistency reliability between the tasks and the total score was high (α = .82). Construct validity was supported for the total score (t(48) = -5.48, d=1.52) and the separate tasks. Moderate ecological validity with the FIM/FAM (r(19) = .44, p < .05) was obtained. Furthermore, severity of injury, Glasgow Coma Scale (GCS), and Length of Unconsciousness, were significantly correlated (r=-.69 p<.01) with the FLOTCA and stronger than the correlation with the demographic variables. The results support the use of the FLOTCA for assessing cognitive functional skills and serve as the basis for planning intervention.

Regular exercise clearly associate with higher pain tolerance, but pain thresholds are affected more ambiguously. In this conection the observation that pain perception is modifiable by physical activity provides promise for the use of non-invasive methods with few side effects for patients with chronic pain conditions.The aim of this study is to test factors such as personality and demographic factors that affect the relationship between physical activity and modifications in pain perception. Psychological Questionnaires: Body Awareness Questionnaire that asks subjects to rate, on a 4 point scale, the degree to which they were currently experiencing symptoms of sympathetic arousal, State Trait Anger Scale, and State Trait Anxiety Scale. Objective methods (cold pressure test) are used only to determine the pain sensation and pain tolerance thresholds. The VAS on the other hand, represents pain as a continuum and is sensitive to change. There was a significant interaction between self reported sympathetic arousal, sex, and anxiety depending on physical activity as well. The results of investigation support this complex, multi-element method for measuring pain as a useful model for studying effects of exercise on the perception of pain and there is reason to find that it might help in the understanding of mechanisms of pain generation.

Sensitively measuring changes in questionnaire scores is essential to identifying whether outcomes are valid and clinically meaningful in a given population. Minimal Important Change (MIC) scores facilitate this interpretation. For people with tinnitus, who often present with a number of co-morbid complaints, the recommended method of evaluating the effectiveness of treatments is to use a self-report questionnaire such as the Tinnitus Functional Index (TFI). The TFI is reported to provide a responsive measure of change in tinnitus severity; however, no valid MIC score exists. The present study aims to identify MIC scores relevant to clinical (patient) or research (participant) populations, using a combination of distribution-based and anchor-based methods. TFI questionnaire data was collected from 150 patients attending NHS audiology clinics and 95 participants who volunteered for a tinnitus research study. Analysis involves integrating Standard Error of Measurement (SEM), Effect size (ES), Reliable Change Index (RC) (Distribution-based) and the global improvement scores (clinical population). In the research population, an MIC score of 22.4 was identified based on the SEM of 8.1. In the clinical population with “no change” in tinnitus, an MIC score of 26.4 was identified (SEM = 9.5). Further analyses integrating these with ES and RC will be presented.

The eight subscales of the Tinnitus Functional Index questionnaire (TFI: 25-item) were designed for individual use to measure intrusiveness, sense of control (SoC), cognition, sleep, auditory, relaxation, quality of life (QOL: 4-item), and emotional aspects of the functional impact of tinnitus. We evaluated the measurement properties of these individual subscales using the Rasch measurement model. 540 people with tinnitus completed the TFI (255 tinnitus patients, 285 research volunteers). Data for the eight subscales were individually fitted to the Rasch measurement model (RUMM 2030). Subscales were assessed for model fit, unidimensionality, person-separation reliability (PSI), and differential item functioning. After removing one misfitting item (QOL22), all 8 subscales showed good fit with non-significant chi-squared values (p > 0.05). They were unidimensional with high PSI estimates ranging 0.77 to 0.92. Significant difference between populations was observed in four items (Intrusiveness3, SoC5, Relaxation8, QOL21), whilst only one item (Emotional25) showed significant gender differences. These items were split to adjust for these differences, improving model fit for each subscale. We conclude the individual subscales provide reliable individual measures of different aspects of the functional impact of tinnitus. Further analyses will assess the relationship between these subscales in testlets.