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Multiple Sclerosis l: Introduction01:19

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Multiple sclerosis is a chronic autoimmune disease of the central nervous system (CNS) that affects the brain, spinal cord, and optic nerves. It is an inflammatory demyelinating disorder and a leading cause of neurological disability in young adults.EpidemiologyMS commonly begins between 20 and 40 years of age and is twice as common in women. Its exact cause remains unclear, but genetic susceptibility contributes, with higher risk in first-degree relatives and identical twins. A greater...
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A Computerized Functional Skills Assessment and Training Program Targeting Technology Based Everyday Functional Skills
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A cluster-randomised controlled feasibility trial evaluating the Cognitive Occupation-Based programme for people with

Sinéad M Hynes1, Christopher P Dwyer2, Alberto Alvarez-Iglesias3

  • 1Discipline of Occupational Therapy, School of Health Sciences, College of Medicine, Nursing and Health Sciences, University of Galway, Galway, Ireland.

Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
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Summary

The Cognitive Occupation-Based programme for Multiple Sclerosis (COB-MS) is a feasible and effective intervention for improving daily functioning in people with MS. This study supports further testing of COB-MS in a definitive trial.

Keywords:
Cluster randomised controlled trialCognitive rehabilitationFeasibilityMultiple sclerosisOccupational therapy

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Area of Science:

  • Neuroscience
  • Rehabilitation Science
  • Occupational Therapy

Background:

  • Cognitive difficulties are prevalent in Multiple Sclerosis (MS), impacting daily life.
  • Existing cognitive programs often lack focus on functional, everyday living skills.
  • The Cognitive Occupation-Based programme for people with Multiple Sclerosis (COB-MS) was developed to address these gaps.

Purpose of the Study:

  • To evaluate the feasibility and initial efficacy of the COB-MS intervention.
  • To assess COB-MS as a cognitive intervention for individuals with MS.
  • To determine if COB-MS meets progression criteria for a definitive trial.

Main Methods:

  • A cluster-randomised controlled feasibility trial was conducted.
  • The COB-MS intervention was delivered remotely by occupational therapists over eight sessions.
  • Data on cognition, quality of life, mood, and functional outcomes (Goal Attainment Scaling) were collected at multiple time points.

Main Results:

  • 118 participants with MS and cognitive difficulties were randomized (58 to COB-MS, 60 to usual care).
  • The COB-MS intervention was found to be feasible, acceptable to participants, and demonstrated positive impacts on daily life.
  • A significant improvement in the primary outcome (Goal Attainment Scaling) was observed in the COB-MS group compared to the control group.

Conclusions:

  • The feasibility trial met its progression criteria, supporting further investigation.
  • Results provide a strong basis for a definitive trial of COB-MS.
  • The COB-MS shows preliminary clinical efficacy for individuals with MS experiencing cognitive challenges.