Table 4.
Other interventions for which sound evidence of impact on activity/participation is still required (i.e. evidence is at level of impairment only OR only limited evidence of impact on activity/participation) — multiple sclerosis (MS)
| Intervention description | Target of the intervention (cognitive, psychosocial, behavioural, emotional) | Target clinical population | Resources, skills, and training required | Evidence-based considerations |
|---|---|---|---|---|
| Spaced retrieval | Cognitive: new learning | Multiple sclerosis (MS) | Requires a therapist with cognitive rehabilitation skills and specific knowledge or training in spaced retrieval | This is recommended as a practice option in MS (Goverover et al., 2018b; Sumowski et al., 2010) |
| Music mnemonics | Cognitive: learning and memory | Multiple sclerosis (MS) | Requires a therapist with cognitive rehabilitation skills and specific knowledge or training in music mnemonics | This is recommended as a practice option in MS (Goverover et al., 2018b; Thaut et al., 2014) |
| CCT programs targeting attention (attention process training and RehaCom) | Cognitive: attention | Multiple sclerosis (MS) |
Requires access to a computer (with a reliable internet connection for some online programs); A therapist with cognitive rehabilitation skills |
Attention process training is recommended as a practice guideline, and RehaCom is recommended as a practice option (Goverover et al., 2018b) |
| CCT programs targeting multiple domains | Cognitive: Multiple cognitive domains | Multiple sclerosis (MS) |
Requires access to a computer (with a reliable internet connection for some online programs); A therapist with cognitive rehabilitation skills |
RehaCom (modules used were attention and concentration, plan a day, divided attention, reaction behaviour, and logical thinking) is recommended as a practice guideline (Goverover et al., 2018b) |
| Cognitive strategies—restorative | Cognitive: Memory span and ‘working memory’ (complex attention skills) | Multiple sclerosis (MS) |
Some interventions require access to a computer (with a reliable internet connection for some online programs); A therapist with cognitive rehabilitation skills |
These interventions include both paper-and-pencil type interventions and computerised interventions, usually lasting a few months, with 3–4 × 1 h intense training sessions per week (Dardiotis et al., 2018; das Nair et al., 2016b; Hamalainen & Rosti-Otajarvi, 2014; Lampit et al., 2019; Rosti-Otajarvi & Hamalainen, 2014; Sigmundsdottir et al., 2016) |
| Multicomponent intervention combining computerised cognitive training with holistic neuropsychological rehabilitation (psychoeducation, compensatory cognitive strategies) |
Cognitive: verbal memory; processing speed; attention; executive function Emotional/psychosocial: depression; fatigue; quality of life |
Multiple sclerosis (MS) |
Requires access to a computer (with a reliable internet connection for some online programs); A therapist with general neuropsychological and/or broad cognitive rehabilitation skills; Knowledge of MS is required |
Evidence for improvements in verbal memory, processing speed, attention and executive functions at the impairment level (das Nair et al., 2016b; Hamalainen & Rosti-Otajarvi, 2014; Sigmundsdottir et al., 2016) Improvements have been found in perceived cognitive functioning, use of compensatory strategies, and attainment of personal rehabilitation goals (Hamalainen & Rosti-Otajarvi, 2014) |
| Multicomponent intervention combining metacognitive strategy training with mindfulness and/or other cognitive rehabilitation |
Cognitive: speed of information processing Emotional/psychosocial: cognitive concerns, achieving personalised goals, stress, fatigue |
Multiple sclerosis (MS) | ‘MaTiMs’, based on this research, is freely available to people with MS in the public health system in Germany |
Some evidence for at least short-term improvements in cognitive concerns, in achieving personalised goals, in coping self-efficacy, stress, and fatigue (Nauta et al., 2023; Baetge et al., 2023; Pöttgen et al., 2015, 2022) Additional mindfulness training leads to longer-lasting improvements in speed of thinking. Effects tend to wane over time, so booster sessions are recommended |