Evidenced-Based Cognitive Rehabilitation for Persons With Multiple Sclerosis

A Review of the Literature

Amanda R. O'Brien, Nancy Chiaravalloti, Yael Goverover, John DeLuca

Research output: Contribution to journalReview article

Abstract

O'Brien AR, Chiaravalloti N, Goverover Y, DeLuca J. Evidenced-based cognitive rehabilitation for persons with multiple sclerosis: a review of the literature. Objectives: To conduct evidence-based review of cognitive rehabilitation intervention research conducted in persons with multiple sclerosis (MS), to classify level of evidence, and to generate recommendations for interventions in this area. Data Sources: An open (no year limits set) search of Medline, PsychInfo, and CINAHL (eliminating repetitions) using combinations of the following terms: attention, awareness, cognition, cognitive, communication, executive, executive function, language, learning, memory, perception, problem solving, reasoning, rehabilitation, remediation, training, and working memory. Reference sections of articles found through the sites were also searched. Study Selection: Studies were chosen based on criteria from previous evidence-based reviews such that articles are excluded from the review if (1) the study was not an intervention, (2) it was a theoretic article, (3) it was a review article, (4) detail was lacking to fully evaluate the intervention, (5) it was not MS-specific, (6) it included a pediatric sample, (7) it was a case report without empirical data to evaluate outcomes, (8) it was not peer-reviewed (also excludes book chapters), (9) it was a pharmacologic intervention, or (10) it was not available for review in English. Data Extraction: Articles were categorized into interventions for attention, learning and memory, executive functioning, or nonspecified/combined cognitive domains. There were 4 reviewers in the current study. All articles were reviewed independently by at least 2 persons and abstracted according to predetermined criteria. There was a final total of 16 articles, which underwent a full review and classification of a level of evidence based on previously published peer-reviewed methodology used for evidence-based reviews. Data Synthesis: The current review yielded 16 studies of cognitive rehabilitation for persons with MS, including 4 class I studies, 5 class II studies, 2 class III studies, and 5 class IV studies. Two intervention methodologies in the area of verbal learning and memory received support for a practice guideline and practice option, respectively. Conclusions: Cognitive rehabilitation in MS is in its relative infancy. More methodologically rigorous research is needed to determine the effectiveness and efficacy of various cognitive rehabilitation interventions. Specific recommendations for future research are given.

Original languageEnglish (US)
Pages (from-to)761-769
Number of pages9
JournalArchives of Physical Medicine and Rehabilitation
Volume89
Issue number4
DOIs
StatePublished - Apr 2008

Fingerprint

Multiple Sclerosis
Rehabilitation
Learning
Verbal Learning
Information Storage and Retrieval
Executive Function
Short-Term Memory
Practice Guidelines
Cognition
Language
Communication
Pediatrics
Research

Keywords

  • Cognition disorders
  • Cognitive therapy
  • Multiple sclerosis
  • Practice guideline
  • Rehabilitation
  • rehabilitation sciences
  • cognitive rehabilitation
  • cognitive rehabilitation intervention
  • rehabilitation intervention

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation

Cite this

Evidenced-Based Cognitive Rehabilitation for Persons With Multiple Sclerosis : A Review of the Literature. / O'Brien, Amanda R.; Chiaravalloti, Nancy; Goverover, Yael; DeLuca, John.

In: Archives of Physical Medicine and Rehabilitation, Vol. 89, No. 4, 04.2008, p. 761-769.

Research output: Contribution to journalReview article

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abstract = "O'Brien AR, Chiaravalloti N, Goverover Y, DeLuca J. Evidenced-based cognitive rehabilitation for persons with multiple sclerosis: a review of the literature. Objectives: To conduct evidence-based review of cognitive rehabilitation intervention research conducted in persons with multiple sclerosis (MS), to classify level of evidence, and to generate recommendations for interventions in this area. Data Sources: An open (no year limits set) search of Medline, PsychInfo, and CINAHL (eliminating repetitions) using combinations of the following terms: attention, awareness, cognition, cognitive, communication, executive, executive function, language, learning, memory, perception, problem solving, reasoning, rehabilitation, remediation, training, and working memory. Reference sections of articles found through the sites were also searched. Study Selection: Studies were chosen based on criteria from previous evidence-based reviews such that articles are excluded from the review if (1) the study was not an intervention, (2) it was a theoretic article, (3) it was a review article, (4) detail was lacking to fully evaluate the intervention, (5) it was not MS-specific, (6) it included a pediatric sample, (7) it was a case report without empirical data to evaluate outcomes, (8) it was not peer-reviewed (also excludes book chapters), (9) it was a pharmacologic intervention, or (10) it was not available for review in English. Data Extraction: Articles were categorized into interventions for attention, learning and memory, executive functioning, or nonspecified/combined cognitive domains. There were 4 reviewers in the current study. All articles were reviewed independently by at least 2 persons and abstracted according to predetermined criteria. There was a final total of 16 articles, which underwent a full review and classification of a level of evidence based on previously published peer-reviewed methodology used for evidence-based reviews. Data Synthesis: The current review yielded 16 studies of cognitive rehabilitation for persons with MS, including 4 class I studies, 5 class II studies, 2 class III studies, and 5 class IV studies. Two intervention methodologies in the area of verbal learning and memory received support for a practice guideline and practice option, respectively. Conclusions: Cognitive rehabilitation in MS is in its relative infancy. More methodologically rigorous research is needed to determine the effectiveness and efficacy of various cognitive rehabilitation interventions. Specific recommendations for future research are given.",
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