Motor function involves complex physiologic processes and requires the integration of multiple systems, including neuromuscular, musculoskeletal, and cardiopulmonary, and neural motor and sensory-perceptual systems. Motor-functional status is indicative of current physical health status, burden of disease, and long-term health outcomes, and is integrally related to daily functioning and quality of life. Given its importance to overall neurologic health and function, motor function was identified as a key domain for inclusion in the NIH Toolbox for Assessment of Neurological and Behavioral Function (NIH Toolbox). We engaged in a 3-stage developmental process to: 1) identify key subdomains and candidate measures for inclusion in the NIH Toolbox, 2) pretest candidate measures for feasibility across the age span of people aged 3 to 85 years, and 3) validate candidate measures against criterion measures in a sample of healthy individuals aged 3 to 85 years (n 5 340). Based on extensive literature review and input from content experts, the 5 subdomains of dexterity, strength, balance, locomotion, and endurance were recommended for inclusion in the NIH Toolbox motor battery. Based on our validation testing, valid and reliable measures that are simultaneously low-cost and portable have been recommended to assess each subdomain, including the 9-hole peg board for dexterity, grip dynamometry for upper-extremity strength, standing balance test, 4-m walk test for gait speed, and a 2-minute walk test for endurance. Neurology Motor function, the ability to use and control muscles and movements, is integrally related to daily functioning and quality of life. Motor function is a complex physiologic process and requires the integration of multiple inputs and systems, including the neuromuscular, neurosensory, musculoskeletal, and cardiopulmonary systems. Impairments in motor function are often indicative of disorders of the central or peripheral nervous systems and can lead to increased risk of activity limitations, participation restrictions, and mortality in people across the lifespan.1,2 Accordingly, assessment of motor function was included as a major domain of the NIH Toolbox Assessment of Neurological and Behavioral Function (NIH Toolbox)-an initiative of the NIH Blueprint for Neuroscience Research that seeks to develop a brief but comprehensive set of standard measures of motor, cognitive, sensory, and emotional function across the age span from 3 to 85 years 3 for use in epidemiologic, longitudinal, and clinical research.Assessing change in motor function across the lifespan is a complex measurement task. Precise measures of motor function frequently require specialized testing environments and costly equipment. 4 Performance-based measures of motor function have demonstrated prognostic and diagnostic value at the individual and population levels 1,2,5 ; however, there is a lack of consistency in how motor function is measured across studies and across the age span that limits the generalizability of research fin...

No abstract

No abstract

The purpose of this study was to compare 2 practical measures of functional endurance. Specifically, the Six-minute Walk Test (SMWT) and Three-minute Step Test (TMST) were compared to determine their appropriateness for use as field tests and inclusion in the NIH Toolbox for Assessment of Neurological and Behavioral Function. Individuals between 14 and 85 years performed both the SMWT and TMST in random order. We documented completion rates, criterion performance, heart rate responses, and subjective exertion associated with the 2 tests. All 189 participants completed the SMWT, but only 73.0% completed the TMST. Those completing the TMST were more likely to be male, report better health, and have a younger age and lower body mass index. The SMWT distance was greater for those who did, versus those who did not, complete the TMST. For those completing both tests, the average distance walked in 6 minutes was 595.9 meters; the average cumulative heart beats during the minute after the TMST was 107.4. Distance walked and cumulative heart beats were correlated weakly. Average heart rate and perceived exertion were significantly higher after the TMST than the SMWT. Post test heart rate and perceived exertion for the 2 tests correlated significantly but not strongly. We conclude that the SMWT is more likely to be completed and is usually less stressful physiologically than the TMST and therefore may be a better option for field testing functional endurance and inclusion in the NIH Toolbox.

Participants had a large variation in their perceived importance of the many risks and benefits of upper limb transplantation. These findings elucidate how potential upper limb transplantation candidates evaluate the benefits and risks of the procedure. The findings can also inform important issues to address and outcomes to assess in the pretransplant and posttransplant settings.

he impact of breast cancer screening on the early detection of cancer is well-documented. 1 Increasing access to screening has contributed to reducing mortality disparities of women from ethnic/minority communities, 2-5 yet the accessibility of screening services remains woefully inadequate for women with physical disabilities. Although a growing body of research documents breast cancer

Not applicable.

49ORIGINAL RESEARCH significantly impact a person's health-related quality of life, including physical, emotional, cognitive, social, functional, and spiritual well-being. 5,6 Cancer and its treatment has been called a "double whammy" for PWD and can lead to the development of secondary medical conditions as well as the exacerbation of the disabling condition itself. [7][8][9] Notwithstanding, PWD are an "unrecognized health disparity population" 10 and are largely absent from the cancer disparities agenda. F ifty-seven million Americans (or 22% of adults over the age of 18 years) live with disabilities, making PWD one of the largest minority groups in the country. 1 Compared with their nondisabled peers, PWD live with a thinner margin of health. 2 Despite myths that "lightening won't strike twice," 3 cancer is the second leading cause of death among PWD. 4 Cancer and its treatment can trigger an array of negative psychosocial responses such as social withdrawal and isolation, depression, and anxiety and canAbstractBackground: Cancer care for people with disabilities (PWD) is rife with uncertainty and obstacles. Not only do PWD have to contend with cancer and treatment-related sequelae, but also its impact on disabling conditions and functional capacity, as well as a health care system lacking accessibility and disability competence. Peer support can address important needs for emotional and informational support. mHealth tools for smart phones, tablets, or laptops hold promise to deliver such support in an accessible and scalable manner. This concept is unexplored for use among PWD with cancer.Objectives: To describe a community-based participatory study that 1) identifies consumer-reported support needs and priorities among PWD and cancer and 2) integrates consumer perspectives into the design of an mHealth cancer support tool to address these needs and priorities.Methods: Part 1 is a thematic analysis of semistructured, qualitative interviews with a purposive sample of experts in health and cancer care for PWD (n = 7) and a convenience sample of cancer survivors with preexisting disabilities (n = 9). In part 2, results were integrated to develop an mHealth peer support tool to addresses identified needs.Results: Themes included 1) barriers across the cancer care continuum, 2) strengths within the disability community, and 3) recommendations for mHealth and peer support. Based on the qualitative findings, we designed a mHealth tool for peer support and information sharing among PWD with cancer. Conclusion:Consumer-informed mHealth tools hold great potential to leverage strengths in the disability community to address emotional and informational needs created by a lack of disability competence across the cancer care continuum.