A Cognitive Occupation-Based Programme for People with Multiple Sclerosis: A Study to Test Feasibility and Clinical Outcomes.
Sean Reilly, Sinéad M Hynes
PMID 29853813WHAT IT FOUND
Goal achievement improved after a 9-week occupation-based cognitive programme for 12 people with MS.
Some memory and attention scores also improved. The pilot had no control group, so it cannot show the programme caused the gains.
Key findings
01Participants' personal daily-life goals improved significantly, and meaningful goals were achieved by follow-up.
02Verbal memory, visual memory and divided attention scores improved significantly.
03Perceived executive functioning did not improve at follow-up compared with baseline.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
This was a pilot with only 12 participants and no control group, so it cannot show that COB-MS caused the outcomes. The programme combined education, remediation, adaption, individual sessions and group sessions, so the contribution of any single component cannot be separated. Participants self-selected and may have been highly motivated to learn and apply the strategies. Only one male participant was included, although multiple sclerosis is more common in females, limiting generalisability to males. Inclusion used self-reported cognitive difficulties on the MSNQ rather than objective impairment, and ceiling effects suggest the cut-off may have been too low. Disease course data were incomplete for the sample, and disease duration varied substantially. Practice effects in the cognitive tests cannot be completely ruled out. The nonparametric tests used are less sensitive than parametric tests, so statistically significant differences may have been missed. Follow-up was 8 weeks, and the paper recommends longer follow-up to determine whether improvements are maintained.
The easy way to misread this
Do not conclude that COB-MS caused the improvements. The programme combined education, remediation, adaption, individual sessions and group sessions, and this was a 12-person pilot with no control group, so the contribution of any single component cannot be separated.