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计算机辅助认知康复治疗多发性硬化症患者:一项多中心随机对照试验的结果,随访六个月。

Computer-assisted cognitive rehabilitation in persons with multiple sclerosis: Results of a multi-site randomized controlled trial with six month follow-up.

机构信息

School of Nursing, The University of Texas at Austin, USA.

School of Nursing, The University of Texas at Austin, USA.

出版信息

Disabil Health J. 2018 Jul;11(3):427-434. doi: 10.1016/j.dhjo.2018.02.001. Epub 2018 Feb 16.

Abstract

BACKGROUND

The effects of multiple sclerosis (MS) on cognition have gained increasing recognition as one of the major disabling symptoms of the disease. Despite the prevalence of these symptoms and their impact on quality of life, limited attention has been given to strategies that might help manage the cognitive changes commonly experienced by persons with MS.

OBJECTIVE

The primary purpose of this study was to determine the effectiveness of a novel computer-assisted cognitive rehabilitation intervention MAPSS-MS (Memory, Attention, Problem Solving Skills in MS) in a multi-site trial with persons with MS.

METHODS

Persons with MS (N = 183) with cognitive concerns were randomly assigned to either the 8-week MAPSS-MS intervention or usual care plus freely available computer games. Participants completed self-report and performance measures of cognitive functioning, compensatory strategies and depression at baseline, immediately after the MAPSS-MS intervention, and three and six months post-intervention. Changes in study outcomes were analyzed using intention to treat methodology, ANOVA with repeated measures, and ANCOVA.

RESULTS

Both groups improved significantly on all outcome measures. The intervention group outperformed the comparison group on all measures, and there were statistically significant differences on selected measures.

CONCLUSION

Findings suggest that MAPSS-MS is a feasible intervention that could be broadly implemented in community settings. It has been shown to be modestly successful in improving cognitive functioning.

摘要

背景

多发性硬化症 (MS) 对认知的影响已逐渐被认为是该疾病的主要致残症状之一。尽管这些症状普遍存在且对生活质量有影响,但对于可能有助于管理 MS 患者常见认知变化的策略关注有限。

目的

本研究的主要目的是在一项多中心试验中确定一种新的计算机辅助认知康复干预措施 MAPSS-MS(多发性硬化症中的记忆、注意力、问题解决技能)对 MS 患者的有效性。

方法

认知能力存在问题的 MS 患者(N=183)被随机分配至 8 周的 MAPSS-MS 干预组或常规护理加免费提供的计算机游戏组。参与者在基线时、MAPSS-MS 干预后立即以及干预后 3 个月和 6 个月完成认知功能、补偿策略和抑郁的自我报告和表现评估。使用意向治疗方法、重复测量方差分析和协方差分析来分析研究结果的变化。

结果

两组在所有结果测量上都有显著改善。干预组在所有测量上的表现均优于对照组,且在某些测量上存在统计学显著差异。

结论

研究结果表明,MAPSS-MS 是一种可行的干预措施,可以在社区环境中广泛实施。它已被证明在改善认知功能方面取得了适度的成功。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5727/6047944/a8a42e80699b/nihms978196f1.jpg

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