scholarly journals A cognitive occupation-based programme for people with multiple sclerosis: A new occupational therapy cognitive rehabilitation intervention

2019 ◽  
Vol 32 (1) ◽  
pp. 41-52 ◽  
Author(s):  
Sinéad M Hynes ◽  
Susan Forwell
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Rehabilitation ◽  
Occupational Therapists ◽  
Cognitive Intervention ◽  
Evidence Based ◽  
Cognitive Difficulties ◽  
Stakeholder Groups ◽  
Everyday Problems ◽  
Purposive Sample

Introduction Cognitive difficulties have been reported to have the greatest effect on function and quality of life in people with multiple sclerosis, affecting 50–60% of people. To date, few interventions have been developed to treat cognitive issues in multiple sclerosis. Here we report on a Cognitive Occupation-Based programme (COB-MS) for people with Multiple Sclerosis an evidence-based intervention to address everyday problems encountered due to cognitive difficulties. The aim of this research was to explore the views of people with multiple sclerosis and occupational therapists on the programme and its potential implementation in practice. Methods Data were elicited from a purposive sample of 12 people from two stakeholder groups, people with multiple sclerosis (n = 5) and occupational therapists (n = 7), through focus groups and interviews. The programme and related materials were presented, and contributions recorded, transcribed and thematically analysed. Results Two main themes were identified from analysis of the data: response to the intervention and challenges to implementing the programme. Occupational therapists agreed that the COB-MS is client-centred. People with multiple sclerosis thought that it was a validating intervention. The overall format was viewed to be useful and feasible. Conclusion The COB-MS for people with Multiple Sclerosis is the first known cognitive intervention using an occupation frame of reference to address difficulties faced among persons with multiple sclerosis and was found to be timely and relevant to the needs of the population.

scholarly journals Treatment of Chronic Pulmonary Heart Disease with Traditional Chinese Medicine: A Protocol for the Development of a Core Outcome Set (COS-TCM-CPHD)

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Bohan Niu ◽  
Mingyan Zhang ◽  
Hui Zi Chua ◽  
Kai Li ◽  
Junhua Zhang
Keyword(s):  
Decision Making ◽  
Heart Disease ◽  
Core Outcome Set ◽  
Evidence Based ◽  
Core Outcome ◽  
Stakeholder Groups ◽  
Pulmonary Heart Disease ◽  
Outcome Set ◽  
Chronic Pulmonary Heart Disease

Background. Treatment of chronic pulmonary heart disease (CPHD), a common disease, has over recent years been studied using traditional Chinese medicine (TCM) due to many high-profile benefits. These can be evaluated by the measurement and analysis of related outcomes. Because of selective reporting bias and the heterogeneity of study outcomes, it is not possible to combine similar studies in a meta-analysis. Consequently, not only does the low quality of original studies fails to support evidence-based decision-making, but also the value of those clinical studies cannot be evaluated. To solve these problems, the development of a core outcome set for traditional Chinese medicines for the treatment of chronic pulmonary heart disease (COS-TCM-CPHD) is required. Methods. The development is conducted in five steps: (1) a library of outcomes through systematic review, the retrieval of libraries from two clinical trials registries, and semistructured interviews is established; (2) following data extraction and analysis of the library of outcomes, each outcome can be classified into seven outcome domains, including TCM disease, symptoms/signs, physical and chemical testing, quality of life, long-term prognosis, economic evaluation, and adverse events to form a preliminary list of outcomes; (3) stakeholder groups for participation are selected; (4) stakeholder groups are invited to participate in two rounds of Delphi surveys to score outcomes and provide additional outcomes; (5) a consensus meeting is organized to produce the final COS-TCM-CPHD. Discussion. The protocol is consistent with the guidelines defined by the Core Outcome Set-STAndardised Protocol (COS-STAP) statement and formulated with reference to Core Outcome Set-STAndards for development (COS-STAD). The COS-TCM-CPHD will improve the consistency of study reports and reduce publication bias, thereby improving the quality of TCM clinical trials and decision-making for evidence-based medicine. The study has been registered on the COMET website (http://www.comet-initiative.org/Studies/Details/1677).

scholarly journals Cognition in multiple sclerosis

Neurology ◽  
2018 ◽  
Vol 90 (6) ◽  
pp. 278-288 ◽  
Author(s):  
James F. Sumowski ◽  
Ralph Benedict ◽  
Christian Enzinger ◽  
Massimo Filippi ◽  
Jeroen J. Geurts ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Deficits ◽  
Cognitive Rehabilitation ◽  
Clinical Care ◽  
Theoretical Models ◽  
Scientific Basis ◽  
Evidence Based ◽  
Extensive Literature ◽  
Current State ◽  
Neural Bases

Cognitive decline is recognized as a prevalent and debilitating symptom of multiple sclerosis (MS), especially deficits in episodic memory and processing speed. The field aims to (1) incorporate cognitive assessment into standard clinical care and clinical trials, (2) utilize state-of-the-art neuroimaging to more thoroughly understand neural bases of cognitive deficits, and (3) develop effective, evidence-based, clinically feasible interventions to prevent or treat cognitive dysfunction, which are lacking. There are obstacles to these goals. Our group of MS researchers and clinicians with varied expertise took stock of the current state of the field, and we identify several important practical and theoretical challenges, including key knowledge gaps and methodologic limitations related to (1) understanding and measurement of cognitive deficits, (2) neuroimaging of neural bases and correlates of deficits, and (3) development of effective treatments. This is not a comprehensive review of the extensive literature, but instead a statement of guidelines and priorities for the field. For instance, we provide recommendations for improving the scientific basis and methodologic rigor for cognitive rehabilitation research. Toward this end, we call for multidisciplinary collaborations toward development of biologically based theoretical models of cognition capable of empirical validation and evidence-based refinement, providing the scientific context for effective treatment discovery.

Evidence-based measurement in multiple sclerosis: the psychometric properties of the physical and psychological dimensions of three quality of life rating scales

2003 ◽  
Vol 9 (4) ◽  
pp. 411-419 ◽  
Author(s):  
A Riazi ◽  
J C Hobart ◽  
D L Lamping ◽  
R Fitzpatrick ◽  
A J Thompson
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Clinical Trials ◽  
Psychometric Properties ◽  
Effect Size ◽  
Evidence Based ◽  
Sf 36 ◽  
Psychological Dimensions ◽  
Selection Of

The selection of measures of quality of life used in clinical trials of multiple sclerosis (MS) should be evidence-based. Head-to -head comparison of measures facilitates the selection of measures. The aim of the study was to compare the psychometric properties of the physical and psychological dimensions in three measures of quality of life to aid choice of the most appropriate scale for use in clinical trials of MS. O ne hundred and twenty-one people with MS (rehabilitation =57; steroids =64) completed a selection of health measures before and after treatment. The psychometric properties of three measures of physical function (MSIS-29 physical, SF-36 physical functioning, FA MS mobility) and three measures of psychological function (MSIS-29 psychological, SF-36 mental health, FA MS emotional well-being) were compared by examining data quality, scaling assumptions, acceptability, reliability, validity and responsiveness. Physical (0.63- 0.71) and psychological (0.70-0.75) scales were substantially correlated indicating they measure related constructs. The MSIS-29 physical and psychological scales satisfied all criteria for internal consistency reliability (physical =0.91; psychological =0.89) and validity. The SF-36 physical scale had a notable floor effect (20%). The FA MS mobility scale had lower reliability (a=0.78) compared to other measures. The MSIS-29 physical (effect size=0.91) and psychological (effect size =0.62) scales were the most responsive. In these three samples, the MSIS-29 had better measurement properties for combined physical and psychological health than the SF-36 and the FA MS.

scholarly journals Computerized Neuropsychological Test Battery CogniSoft for Assessment of Cognition in Patients with Multiple Sclerosis

2020 ◽  
Vol 24 (4) ◽  
pp. 371-380
Author(s):  
Lyudmila Todorova ◽  
◽  
Valentina Ignatova ◽  
Jivko Surchev ◽  
◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Rehabilitation ◽  
Neuropsychological Test ◽  
Neuropsychological Testing ◽  
Poor Quality ◽  
Cognitive Status ◽  
Global Trends ◽  
Significant Difference ◽  
Overall Evaluation

Cognitive dysfunction is a leading cause of disability in multiple sclerosis (MS) and is associated with unemployment, need of assistance with daily activities and poor quality of life. The introduction of neuropsychological testing and monitoring of cognitive status as part of the overall evaluation of MS patients in parallel with clinical and paraclinical parameters is highly recommended. Recent studies have demonstrated a better perception and preference for computerized cognitive tests than classic variants, with no significant difference in results. In accordance with global trends, a bilingual computer system CogniSoft for assessment and rehabilitation of cognitive status in persons with MS has been developed, including: 1) a set of diagnostic tests for evaluation of memory and executive functions based on the nature of Brief International Cognitive Assessment for MS (BICAMS); 2) a set of games for cognitive rehabilitation. Questionnaire for depression (Beck Depression Inventory – BDI-II) will be filled before conduction of the neuropsychological tests for differentiation of possible depression which could interfere with the results. The CogniSoft information system will incorporate two approaches for evaluation of neuropsychological results which will allow early detection of cognitive impairments in these patients, which will initiate timely cognitive rehabilitation.

scholarly journals An Immersive Virtual Reality Exergame for People with Parkinson’s Disease

2020 ◽  
pp. 138-145
Author(s):  
Weiqin Chen ◽  
Martin Bang ◽  
Daria Krivonos ◽  
Hanna Schimek ◽  
Arnau Naval
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Virtual Reality ◽  
Physical Exercise ◽  
Cognitive Rehabilitation ◽  
Motor System ◽  
Neurodegenerative Disorder ◽  
Evidence Based ◽  
Immersive Virtual Reality

AbstractParkinson’s disease is a neurodegenerative disorder that affects primarily motor system. Physical exercise is considered important for people with Parkinson’s disease (PD) to slow down disease progression and maintain abilities and quality of life. However, people with PD often experience barriers to exercises that causes low-level adherence to exercise plans and programs. Virtual Reality (VR) is an innovative and promising technology for motor and cognitive rehabilitation. Immersive VR exergames have potential advantages by allowing for individualized skill practice in a motivating interactive environment without distractions from outside events. This paper presents an immersive virtual reality (VR) exergame aiming at motor training on fingers and hand-and-eye coordination. The results from the usability study indicate that immersive VR exergames have potential to provide motivating and engaging physical exercise for people with PD. Through this research, we hope to contribute to evidence-based design principles for task-specific immersive VR exergames for patients with Parkinson’s Disease.

scholarly journals Reporting interventions in trials evaluating cognitive rehabilitation in people with multiple sclerosis: a systematic review

2017 ◽  
Vol 32 (2) ◽  
pp. 243-254 ◽  
Author(s):  
Jacqueline R Mhizha-Murira ◽  
Avril Drummond ◽  
Olga A Klein ◽  
Roshan dasNair
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Deficits ◽  
Cognitive Rehabilitation ◽  
Grey Literature ◽  
Executive Dysfunction ◽  
Control Group ◽  
Delivery Mode ◽  
Quality Of Reporting ◽  
Author Citations

Objective: To determine the quantity and quality of description of cognitive rehabilitation for cognitive deficits in people with multiple sclerosis, using a variety of published checklists, and suggest ways of improving the reporting of these interventions. Data sources: A total of 10 electronic databases were searched, including MEDLINE, EMBASE, CINAHL and PsycINFO, from inception to May 2017. Grey literature databases, trial registers, reference lists and author citations were also searched. Review methods: Papers were included if participants were people with multiple sclerosis aged 18 years and over and if the effectiveness of cognitive rehabilitation in improving functional ability for memory, attention or executive dysfunction, with or without a control group, was being evaluated. Results: A total of 54 studies were included in this review. The reporting of a number of key aspects of cognitive rehabilitation was poor. This was particularly in relation to content of interventions (reported completely in 26 of the 54 studies), intervention procedures (reported completely in 16 of the 54 studies), delivery mode (reported completely in 24 of the 54 studies) and intervention mechanism of action (reported completely in 21 of the 54 studies). Conclusion: The quality of reporting of cognitive rehabilitation for memory, attention and executive function for multiple sclerosis, across a range of study designs, is poor. Existing reporting checklists do not adequately cover aspects relevant to cognitive rehabilitation, such as the approaches used to address cognitive deficits. Future checklists could consider these aspects we have identified in this review.

scholarly journals Comparison of Cognitive Rehabilitation versus Donepezil Therapy on Memory Performance, Attention, Quality of Life, and Depression among Multiple Sclerosis Patients

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Mohammad Mahdi Shahpouri ◽  
Majid Barekatain ◽  
Mahgol Tavakoli ◽  
Omid Mirmosayyeb ◽  
Ali Safaei ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Multiple Sclerosis ◽  
Cognitive Rehabilitation ◽  
Digit Span ◽  
Memory Performance ◽  
Intergroup Comparison ◽  
Multiple Sclerosis Patients ◽  
Memory Questionnaire

Background. Multiple sclerosis (MS) is a demyelinating disease of the central nervous system that affects cognitive performance and leads to depression and decreased quality of life (QOL). The current study aims to assess the effects of cognitive rehabilitation versus donepezil therapy on memory, attention, depression, and QOL in MS patients compared to placebo and control groups. Methods. Eighty MS patients were randomly selected from parallel randomized trials and divided into four groups: A: cognitive rehabilitation (10 sessions of 120 minutes), B: control (no intervention), C: donepezil (10 mg daily), and D: placebo. Patients received the intervention for three months. They were assessed for cognitive status, depression, and QOL prior to the intervention and immediately after that using abbreviated mental test (AMT), prospective and retrospective memory questionnaire (PRMQ), everyday memory questionnaire (EMQ), digit span, MSQOL-54, and second edition Beck depression inventory (BDI). We compared scores between groups after the intervention, as well as the progression of scores in every single group. Results. The cognitive rehabilitation group showed improvement in EMQ, RPMQ, digit span, physical and mental health subscales of MSQOL54, and depression P < 0.05 . We observed the same effect for donepezil except for the digit span test P = 0.15 . Intergroup comparison of scores showed the superiority of cognitive rehabilitation over donepezil in digit span, depression, and mental health scores. Conclusion. Both donepezil and cognitive rehabilitation effectively improve memory performance, attention, depression, and QOL in MS patients. Cognitive rehabilitation is superior altogether. This study is registered with the Iranian registry of clinical trials http://clinicaltrials.gov/ct2/show/IRCT2016042227522N1.

scholarly journals Pediatric Multiple Sclerosis and Cognition: A Review of Clinical, Neuropsychologic, and Neuroradiologic Features

2017 ◽  
Vol 2017 ◽  
pp. 1-11 ◽  
Author(s):  
Ozgul Ekmekci
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Social Life ◽  
Cognitive Rehabilitation ◽  
Neuropsychological Test ◽  
Disease Onset ◽  
Long Term Effects ◽  
Cognitive Domains

Multiple sclerosis (MS) is an inflammatory demyelinating and neurodegenerative disease. Although cognitive impairment has been well established in adult patients with MS, its occurrence in patients with pediatric-onset MS has recently been reported. In this review, I discuss the main features of cognitive impairment in pediatric MS as determined by long-term follow-up studies, neuropsychiatric test batteries, and the results of neuroradiological imaging studies that investigated the pathogenesis of pediatric MS. The most commonly affected cognitive domains in adults are attention, processing speed, and visuomotor skills; language and intelligence are also affected in pediatric MS. A young age at disease onset is the strongest risk factor for these impairments, which may be due to the effect of inflammatory demyelination and neurodegeneration on the developing central nervous system and neural networks in children. Cognitive impairment has long-term effects on patients’ academic life and the quality of their social life. Therefore, all patients with pediatric MS should be screened and monitored for cognitive impairment. This review also highlights the need for neuropsychological test batteries that assess different cognitive domains in children and adolescents with multiple sclerosis and for cognitive rehabilitation programs to improve the quality of their academic and social life.

scholarly journals Exercise as Medicine in Multiple Sclerosis—Moving Beyond Compensatory Benefits

US Neurology ◽  
2017 ◽  
Vol 13 (02) ◽  
pp. 70 ◽  
Author(s):  
Kathleen M Zackowski ◽  
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Nervous System ◽  
Physical Exercise ◽  
Exercise Prescription ◽  
Bladder Function ◽  
Evidence Based ◽  
Pathophysiologic Mechanisms

Many studies have shown that physical exercise improves multiple sclerosis (MS) symptoms, including cognition, fatigue, bowel and bladder function, depression, and overall quality of life. However, the pathophysiologic mechanisms responsible for these symptomatic changes remain elusive. Exercise offers a likely path for addressing progressive MS, nervous system repair, and as a wellness approach for people with MS. We as a community need to work toward gaining information to establish an evidence-based exercise prescription for people living with MS.

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