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Cognitive function in multiple sclerosis improves with telerehabilitation: Results from a randomized controlled trial
Leigh E Charvet1, Jie Yang2, Michael T Shaw1
1Department of Neurology, NYU School of Medicine, New York, New York, United States of America.
Plos One
|May 12, 2017
Summary
Adaptive cognitive remediation (ACR) training improved cognitive functioning in adults with multiple sclerosis (MS) more than computer games. This home-based telerehabilitation offers a promising approach for cognitive dysfunction in MS.
Area of Science:
- Neuroscience
- Rehabilitation Medicine
- Cognitive Psychology
Background:
- Cognitive impairment is prevalent in over 50% of individuals with multiple sclerosis (MS).
- Existing treatments often require in-person visits, posing accessibility challenges.
Purpose of the Study:
- To evaluate the efficacy of an adaptive online cognitive remediation (ACR) program compared to ordinary computer games for improving cognitive function in adults with MS.
- To assess the feasibility of a remotely-supervised, home-based telerehabilitation approach.
Main Methods:
- A double-blind, randomized, active-placebo-controlled trial involving adults with MS.
- Participants were assigned to either an ACR program or an active control (computer games) for 60 hours over 12 weeks.
- Cognitive functioning was measured using a neuropsychological composite score from baseline to study end.
Main Results:
- The ACR group showed significantly greater improvement in cognitive functioning compared to the active control group (mean change in composite z score: 0.25 vs. 0.09, p = 0.03).
- Despite longer training hours in the active control group, the ACR program yielded superior cognitive benefits.
- The telerehabilitation approach demonstrated rapid recruitment and high participant compliance.
Conclusions:
- Adaptive, computer-based cognitive remediation delivered remotely from home can significantly improve cognitive functioning in individuals with multiple sclerosis.
- This telerehabilitation strategy is effective, accessible, and potentially applicable to other neurological conditions causing cognitive dysfunction.
