Cognitive rehabilitation program in patients with multiple sclerosis: A pilot study.

INTRODUCTION: In recent years, there has been an increase of studies dedicated to cognitive rehabilitation in patients with multiple sclerosis (MS); however, few of these analyze the impact on such variables as cognitive reserve. The study aims to explore the effects of a cognitive rehabilitation program comprising a combination of cognitive and physical exercises, as well as group sessions to improve cognitive performance, emotional state, and cognitive reserve index. METHOD: Fifty patients with MS were subdivided into 2 groups: the control group, which performed aerobic exercise (n=25), and the experimental group (n=25), which participated in the integrated cognitive rehabilitation program (ICRP). All participants were evaluated 3 times (baseline, post-treatment, and long-term) with the Brief Repeatable Battery of Neuropsychological Tests, Cognitive Reserve Scale, Beck Depression Inventory, and a scale evaluating trait and state anxiety. RESULTS: Compared with the control group, patients in the experimental group showed improvements in cognitive function, with significant changes in measures of information processing speed, attention, memory, cognitive reserve index, and long-term mood. CONCLUSIONS: The ICRP was effective in improving cognitive and emotional function in MS, and increased the cognitive reserve index.

Fear of Relapse Scale: Spanish version and psychometric characteristics in a sample of patients with Relapsing-Remitting multiple sclerosis.

INTRODUCTION: Relapses are a hallmark of multiple sclerosis, being a characteristic feature of relapsing-remitting multiple sclerosis (RRMS). The occurrence of a relapse constitutes a source of significant discomfort that impacts all domains of daily life of patients with multiple sclerosis (PwMS). In this study we first explored the psychometric properties of the Spanish version of the Fear of Relapse Scale (FoR) in a sample of patients with RRMS. Besides, we explored the relationship between the Fear of Relapse Scale with fatigue and cognitive perceived deficits in our PwMS sample. METHODS: An online cross-sectional survey was conducted on 173 MS patients from 12 Spanish-speaking countries (Argentina, Mexico, Uruguay, Dominican Republic, Spain, Cuba, Colombia, Guatemala, Chile, Paraguay, Peru, and El Salvador). Confirmatory factor analysis (CFA) was performed to assess the factor structure of the scale. Multiple linear regression was used to evaluate the effects of health self-perception, fatigue, and perceived cognitive deficits over fear of relapse. RESULTS: The three-factor model in the CFA yielded a good model fit (χ2/df = 2.25, P < .001, RMSEA = .078, CFI = .91). McDonalds' Omega of the FoR (Spanish version) was .91. There was a statistically significant inverse correlation between FoR and health self-perception, and a positive correlation between FoR, fatigue, and perceived cognitive deficits. Finally, level of fatigue was a predictor of fear of relapse. CONCLUSIONS: The Spanish version of the Fear of Relapse Scale is a valid and reliable instrument to explore the experience of fear of relapse in patients with RRMS.

Cognitive rehabilitation program in patients with multiple sclerosis: A pilot study.

INTRODUCTION: In recent years, there has been an increase of studies dedicated to cognitive rehabilitation in patients with multiple sclerosis (MS); however, few of these analyze the impact on such variables as cognitive reserve. The study aims to explore the effects of a cognitive rehabilitation program comprising a combination of cognitive and physical exercises, as well as group sessions to improve cognitive performance, emotional state, and cognitive reserve index. METHOD: Fifty patients with MS were subdivided into 2 groups: the control group, which performed aerobic exercise (n=25), and the experimental group (n=25), which participated in the integrated cognitive rehabilitation program (ICRP). All participants were evaluated 3 times (baseline, post-treatment, and long-term) with the Brief Repeatable Battery of Neuropsychological Tests, Cognitive Reserve Scale, Beck Depression Inventory, and a scale evaluating trait and state anxiety. RESULTS: Compared with the control group, patients in the experimental group showed improvements in cognitive function, with significant changes in measures of information processing speed, attention, memory, cognitive reserve index, and long-term mood. CONCLUSIONS: The ICRP was effective in improving cognitive and emotional function in MS, and increased the cognitive reserve index.

[Cognitive training combined with aerobic exercises in multiple sclerosis patients: a pilot study]. / Entrenamiento cognitivo combinado con ejercicios aerobicos en pacientes con esclerosis multiple: estudio piloto.

INTRODUCTION: The scientific evidences associated to the effectiveness of different techniques of cognitive rehabilitation are still contradictory. AIM: To compare a program of combined training (physical and cognitive) in front of a program of physical training and to observe their effectiveness about the optimization of the cognitive functions in patients with multiple sclerosis (MS). PATIENTS AND METHODS: It was carried out an experimental study in 32 patients with MS. The patients were distributed in two groups: 16 to the experimental group (combined cognitive training with aerobic exercises) and 16 patients to the control group (aerobic exercises). The intervention was planned for six weeks combining cognitive tasks by means of a game of dynamic board of cubes and signs (TaDiCS ®) and a program of aerobic exercises. The Brief Repeatable Battery of Neuropsychological Test and the Stroop Test were applied to evaluate the cognitive yield. Also, the Beck Depression Inventory was administered. RESULTS: There were found significant differences in the intergrupal analysis after the intervention in the variable learning and visuoespacial long term memory (p = 0.000), attention (p = 0.026) and inhibitory control (p = 0.007). Also, in the intragroup analysis there were found significant differences in these variables and information processing speed in the group that received the combined training. These patients also showed a significant improvement in the emotional state (p = 0.043). CONCLUSION: The cognitive training combined with the aerobic exercises is effective to improve the cognitive performance.

TITLE: Entrenamiento cognitivo combinado con ejercicios aerobicos en pacientes con esclerosis multiple: estudio piloto.Introduccion. Las evidencias cientificas asociadas a la efectividad de distintas tecnicas de rehabilitacion cognitiva todavia resultan contradictorias. Objetivo. Comparar un programa de entrenamiento combinado (fisico y cognitivo) frente a un programa de entrenamiento fisico y observar su eficacia sobre la optimizacion de las funciones cognitivas en pacientes con esclerosis multiple (EM). Pacientes y metodos. Se realizo un estudio experimental en 32 pacientes con EM. Los pacientes se distribuyeron en dos grupos: 16 al grupo experimental (entrenamiento cognitivo combinado con ejercicios aerobicos) y 16 al grupo control (ejercicios aerobicos). La intervencion se planifico para seis semanas combinando tareas cognitivas mediante un juego de tablero dinamico de cubos y signos (TaDiCS ®) y un programa de ejercicios aerobicos. Se aplico la bateria breve repetible de tests neuropsicologicos y el test de Stroop para evaluar el rendimiento cognitivo. Ademas, se administro el inventario de depresion de Beck. Resultados. Se encontraron diferencias significativas en el analisis intergrupo despues de la intervencion en las variables aprendizaje y memoria a largo plazo visuoespacial (p = 0,000), atencion (p = 0,026) y control inhibitorio (p = 0,007). Asimismo, en el analisis intragrupo se encontraron diferencias significativas en estas variables y en la velocidad en el procesamiento de la informacion en el grupo que recibio el entrenamiento combinado. Estos pacientes tambien mostraron una mejoria significativa en el estado de animo (p = 0,043). Conclusion. El entrenamiento cognitivo combinado con los ejercicios aerobicos resulta eficaz para mejorar el funcionamiento cognitivo.