SPONSORED RESEARCH: Toward the feasibility of administering and implementing robust cognitive tests in spinal cord injury rehabilitation
July 9, 2026
Read a Q&A Below:
Manrui Zhang, PhD and colleagues at Northwestern University's Feinberg School of Medicine Department of Medical Social Sciences recently won a grant titled, “Toward the feasibility of administering and implementing robust cognitive tests in spinal cord injury rehabilitation” from the Craig H. Neilsen Foundation.
What are the aims of the project?
People with Spinal Cord Injury (SCI) are at an increased risk of having cognitive impairment, resulting in poor functional recovery. Clinical recognition of cognitive impairment is frequently delayed or absent among people with SCI, as clinicians in rehabilitation primarily use informal, non-standardized approaches to assess cognitive function based on observation or self-report, lacking the consistency and sensitivity to detect mild deficits in different cognitive domains. Some standardized cognitive tests are available but limited attention has been placed on summarizing or evaluating the pragmatic properties or the practical aspects of the test administration and implementation, despite the many accessibility challenges faced by this population. The overarching goal of this project is to provide a systematic understanding of the potential feasibility of administering and implementing standardized cognitive tests among people with SCI across different rehabilitation settings.
What are your next steps?
This project is an expansion of a prior one-year project funded by Paralyzed Veterans of America to specifically develop accommodation solutions for people with spinal cord injury to take the NIH Toolbox Cognition Battery. In this two-year project, I will conduct a scoping review to synthesize existing evidence on which and how standardized cognitive tests have been used in different SCI rehabilitation settings. Psychometric and pragmatic properties will be summarized, based on which an evidence map will be generated and integrated into the Rehabilitation Measure Database. An online survey and focus groups will then be conducted among SCI rehabilitation professionals of different disciplines from five rehabilitation institutions and multiple professional networks nationwide. This evidence-based approach incorporating voice from stakeholders will provide first-hand knowledge on the context-specific measurement options and implementation determinants (e.g. challenges and facilitators) for conducting cognitive testing in sub-acute SCI rehabilitation settings.
What do you hope will come out of this funded research?
The immediate deliverables of this project are an evidence map and implementation recommendations to support researchers and clinicians in the selection of cognitive measures and the design of a context-sensitive testing protocol in real-world rehabilitation settings. Additionally, I will gain valuable training and early-career support to specialize in SCI rehabilitation, implementation science, and mixed-method research as the PI of this research. In the future, I envision this research can 1) serve as a blueprint for designing a pilot study to field test the feasible implementation of robust cognitive testing in SCI rehabilitation; and 2) provide important insights into improving accessibility of standardized cognitive tests. In the long-term, I would like to further explore the challenges and facilitators to support scalable and sustainable implementation across different institutions to promote more reliable and proactive identification of cognitive impairment during SCI rehabilitation.