Cognitive rehabilitation for attention and memory in people with multiple sclerosis: a randomized controlled trial (CRAMMS)
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Published:2019-11-26
Issue:2
Volume:34
Page:229-241
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ISSN:0269-2155
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Container-title:Clinical Rehabilitation
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language:en
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Short-container-title:Clin Rehabil
Author:
Lincoln Nadina B1ORCID, Bradshaw Lucy E2, Constantinescu Cris S3, Day Florence2, Drummond Avril ER4, Fitzsimmons Deborah5, Harris Shaun5, Montgomery Alan A2, das Nair Roshan67ORCID, Morgan Miriam, Scott Julia, Evans Susan, McKeown Shirlee, Bharadia Trishna, Moore Perry, Young Carolyn, Sharrack Basil, Isaac Claire, Griffths David, Fixter Vera, Hanley Laura, Evans Stephen, Palmer Lena, Tyrell Tracy, Gaughan Shannon, Elliot Gemma, Keogh Sophie, Oldknow Helen, Edwards Catherine, Schofield Nigel, Clarke Sara, Crossley Kara, Griffiths Holly, Knight Cara, Martin Kristy, Cunliffe Alexandra, Pollard Catherine, Wilson John, Trigg Emma, Vanzan Serena, Dalton Joanna, Pegnall Stephanie, Carpenter Hannah, Cogger Heather, Harnell Rachel, Klein Olga, Mhizha-Murira Jacqueline, Powers Katie, Squires Luke, Sprange Kirsty, Evans Amy, Hobbs Jo, Wakefield Natalie, Barnes Brian, Crone Monica, Foster Matthew, Rumsey Chris, Erven Alexandra, Moss-Morris Rona, Bowen Audrey, O’Connor Rory, Freeman Jenny, Taylor Rod, Rose Anita
Affiliation:
1. Division of Rehabilitation and Ageing, Queen’s Medical Centre, University of Nottingham, Nottingham, UK 2. Nottingham Clinical Trials Unit, University of Nottingham, Nottingham, UK 3. Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK 4. School of Health Sciences, University of Nottingham, Nottingham, UK 5. Swansea Centre for Health Economics, Swansea University, Swansea, UK 6. Division of Psychiatry & Applied Psychology, University of Nottingham, Nottingham, UK 7. Institute of Mental Health, Nottingham, UK
Abstract
Objective: To assess the clinical and cost-effectiveness of cognitive rehabilitation for attention and memory problems in people with multiple sclerosis. Design: Multicentre, pragmatic, randomized controlled trial. Setting: Community Participants: People with multiple sclerosis aged 18–69 years, who reported cognitive problems in daily life and had cognitive problems on standardized assessment. Interventions: A group cognitive rehabilitation programme delivered in 10 weekly sessions in comparison with usual care. Main measures: The primary outcome was the Multiple Sclerosis Impact Scale Psychological subscale at 12 months after randomization. Secondary outcomes included measures of everyday memory problems, mood, fatigue, cognitive abilities and employment at 6 and 12 months after randomization. Results: In all, 245 participants were allocated to cognitive rehabilitation and 204 to usual care. Mean Multiple Sclerosis Impact Scale Psychological at 12 months was 22.2 (SD = 6.1) for cognitive rehabilitation and 23.4 (SD = 6.0) for usual care group; adjusted difference −0.6, 95% confidence interval (CI) = −1.5 to 0.3, P = 0.20. No differences were observed in cognitive abilities, fatigue or employment. There were small differences in favour of cognitive rehabilitation for the Multiple Sclerosis Impact Scale Psychological at 6 months and everyday memory and mood at 6 and 12 months. There was no evidence of an effect on costs (−£808; 95% CI = −£2248 to £632) or on quality-adjusted life year gain (0.00; 95% CI = −0.01 to 0.02). Conclusion: This rehabilitation programme had no long-term benefits on the impact of multiple sclerosis on quality of life, but there was some evidence of an effect on everyday memory problems and mood.
Funder
Health Technology Assessment Programme
Publisher
SAGE Publications
Subject
Rehabilitation,Physical Therapy, Sports Therapy and Rehabilitation
Cited by
12 articles.
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