A randomized controlled trial of a cognitive rehabilitation intervention for persons with multiple sclerosis

Clin Rehabil. 2012 Oct;26(10):882-93. doi: 10.1177/0269215511434997. Epub 2012 Feb 2.

Abstract

Objective: To explore the feasibility and effects of a computer-assisted cognitive rehabilitation intervention - Memory, Attention, and Problem Solving Skills for Persons with Multiple Sclerosis (MAPSS-MS) - for persons with multiple sclerosis on cognitive performance, memory strategy use, self-efficacy for control of symptoms and neuropsychological competence in activities of daily living (ADL).

Design: A randomized controlled single-blinded trial with treatment and wait list control groups.

Setting: Southwestern United States.

Subjects: Convenience sample of 61 persons (34 treatment, 27 wait list control) with multiple sclerosis (mean age 47.9 years, SD 8.8).

Intervention: The eight-week MAPSS-MS intervention program included two components: (a) eight weekly group sessions focused on building efficacy for use of cognitive compensatory strategies and (b) a computer-assisted cognitive rehabilitation program with home-based training.

Outcome measures: A neuropsychological battery of performance tests comprising the Minimal Assessment of Cognitive Function in Multiple Sclerosis (MACFIMS) and self-report instruments (use of memory strategies, self-efficacy for control of multiple sclerosis and neuropsychological competence in ADL) were completed at baseline, two months (after classes), and at five months.

Results: Both groups improved significantly (P < 0.05) over time on most measures in the MACFIMS battery as well as the measures of strategy use and neuropsychological competence in ADL. There was a significant group-by-time interaction for scores on the measures of verbal memory and the use of compensatory strategies.

Conclusions: The MAPSS-MS intervention was feasible and well-accepted by participants. Given the large relative increase in use of compensatory strategies by the intervention group, it holds promise for enhancing cognitive function in persons with multiple sclerosis.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Analysis of Variance
  • Attention
  • Cognition Disorders / complications
  • Cognition Disorders / diagnosis
  • Cognition Disorders / rehabilitation*
  • Cognitive Behavioral Therapy / methods*
  • Computer-Assisted Instruction / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Memory Disorders / complications
  • Memory Disorders / diagnosis
  • Memory Disorders / rehabilitation
  • Middle Aged
  • Multiple Sclerosis / complications
  • Multiple Sclerosis / diagnosis
  • Multiple Sclerosis / rehabilitation*
  • Neuropsychological Tests
  • Problem Solving
  • Reference Values
  • Severity of Illness Index
  • Single-Blind Method
  • Task Performance and Analysis
  • Treatment Outcome
  • Young Adult