Comparing the Effectiveness of Computer-Based, Manual-based, and Combined Cognitive Rehabilitation on Cognitive Functions in Relapsing-Remitting Multiple Sclerosis Patients

Abstract

Introduction: This study aimed to compare the effectiveness of computer-based, manual-based, and combined cognitive rehabilitation to improve cognitive functions among patients with Relapsing-Remitting Multiple Sclerosis (RRMS). Methods: This was a quasi-experimental study with a pre-test-post-test, and a 2-month follow-up, as well as a control group design. Sixty female patients with RRMS were selected by convenience sampling technique. Then they were randomly assigned into three experimental groups (computer-based, manual-based, and combined cognitive rehabilitation, each group including 12 patients), a placebo group (12 patients), and a control group (12 patients). The interventions were conducted in 21 sessions for the experimental groups for 5 months. The placebo group received physical rehabilitation intervention, and the control group received no intervention. The study participants were assessed by Psychiatric-Neurological Profile, Mini-Mental State Examination, Kurtzke Expanded Disability Status Scale, Stroop Color and Word Test, Wisconsin Card Sorting Test, and Paced Auditory Serial Addition Test. The obtained data were analyzed by repeated-measures multivariate analysis of variance in SPSS. Results: The effect of group factor was not significant (η2=0.129), but the effect of time (η2=0.884) and interaction effect of time and group (η2=0.295) were statistically significant (P0.05). In the post-test totally and in Follow-up partially, all comparisons among three experimental groups with control and placebo groups were statistically significant (P<0.05). Conclusion: Cognitive rehabilitation was effective in improving cognitive functions in patients with RRMS. Thus, these interventions are recommended for application, along with other treatment protocols to treat RRMS in clinical settings.

Keywords

• cognitive rehabilitation
• executive functions
• working memory
• selective attention
• multiple sclerosis (ms)