Contributions
Abstract: P1756
Type: Poster Sessions
Abstract Category: N/A
Background: 40-60% of people with multiple sclerosis (pwMS) have attention and memory problems. Cognitive rehabilitation, a structured set of therapeutic activities designed to support people with cognitive dysfunctions, is believed to be effective, but the evidence is inconclusive.
Methods: This was a multi-centre, randomised controlled trial investigating the effectiveness of group-based cognitive rehabilitation for pwMS. Consenting participants aged 18-69 years with confirmed memory problems, and able to travel to attend group sessions were individually randomised in a ratio of 6:5 to cognitive rehabilitation plus usual care or usual care alone. Intervention groups received 10 sessions of a manualised group treatment. Follow-up was 6 and 12 months after randomisation. The primary outcome was the Multiple Sclerosis Impact Scale Psychological subscale (MSIS-Psy) at 12 months. Secondary outcomes included the Everyday Memory Questionnaire participant and relative versions, and the General Health Questionnaire-30.
Results: 449 participants were randomised with 387 (214 intervention, 173 in control) included in the primary analysis. At 12 months mean MSIS-Psy score was 22.2 [SD 6.1] in the intervention, 23.4 [SD 6.0] for usual care with adjusted difference in means -0.6, 95% CI -1.5 to 0.3, p=0.20. At 6 months the adjusted difference in mean MSIS-Psy was -0.9, 95% CI -1.7 to -0.1, p=0.03. There were small differences between the groups in some of the other secondary outcomes favouring intervention.
Discussion: The results showed no long-term effect of cognitive rehabilitation on quality of life but did suggest small gain in quality of life at 6 months, a reduction in self-reported memory problems and an improvement in mood. The modest gains may have been because the participants had a relatively high proportion of cognitive problems in daily life at recruitment. Further research should identify who might benefit most from this type of cognitive rehabilitation.
Trial Registration: ISRCTN09697576
Disclosure: This research was funded by the NIHR Health Technology Assessment programme (project number 12/190/05). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.
The authors declare no competing interests.
Abstract: P1756
Type: Poster Sessions
Abstract Category: N/A
Background: 40-60% of people with multiple sclerosis (pwMS) have attention and memory problems. Cognitive rehabilitation, a structured set of therapeutic activities designed to support people with cognitive dysfunctions, is believed to be effective, but the evidence is inconclusive.
Methods: This was a multi-centre, randomised controlled trial investigating the effectiveness of group-based cognitive rehabilitation for pwMS. Consenting participants aged 18-69 years with confirmed memory problems, and able to travel to attend group sessions were individually randomised in a ratio of 6:5 to cognitive rehabilitation plus usual care or usual care alone. Intervention groups received 10 sessions of a manualised group treatment. Follow-up was 6 and 12 months after randomisation. The primary outcome was the Multiple Sclerosis Impact Scale Psychological subscale (MSIS-Psy) at 12 months. Secondary outcomes included the Everyday Memory Questionnaire participant and relative versions, and the General Health Questionnaire-30.
Results: 449 participants were randomised with 387 (214 intervention, 173 in control) included in the primary analysis. At 12 months mean MSIS-Psy score was 22.2 [SD 6.1] in the intervention, 23.4 [SD 6.0] for usual care with adjusted difference in means -0.6, 95% CI -1.5 to 0.3, p=0.20. At 6 months the adjusted difference in mean MSIS-Psy was -0.9, 95% CI -1.7 to -0.1, p=0.03. There were small differences between the groups in some of the other secondary outcomes favouring intervention.
Discussion: The results showed no long-term effect of cognitive rehabilitation on quality of life but did suggest small gain in quality of life at 6 months, a reduction in self-reported memory problems and an improvement in mood. The modest gains may have been because the participants had a relatively high proportion of cognitive problems in daily life at recruitment. Further research should identify who might benefit most from this type of cognitive rehabilitation.
Trial Registration: ISRCTN09697576
Disclosure: This research was funded by the NIHR Health Technology Assessment programme (project number 12/190/05). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.
The authors declare no competing interests.