I think therefore I do: A Cognitive Occupation-Based programme for people with Multiple Sclerosis (COB-MS)

Background: Multiple sclerosis (MS) is the most common disabling neurological condition in young and middle-aged adults and can impact a wide-range of activities from work to community participation. Difficulties with... [ view full abstract ]

Background:
Multiple sclerosis (MS) is the most common disabling neurological condition in young and middle-aged adults and can impact a wide-range of activities from work to community participation. Difficulties with cognition are present in 50-60% of people with MS and impact employment and daily roles and responsibilities. Despite the high prevalence and it consequences, there are few treatment options that address coping with cognitive challenges in the face of everyday life demands. To address this gap the COB-MS was developed to identify, understand and implement strategies to take control & manage cognitive difficulties.
Objective: To develop an ecological valid occupation-based intervention to address the impact of impaired cognition in the lives of persons with MS.
Method:
A preliminary version of the COB-MS was developed (participant and facilitator manuals) based on published evidence and clinical expertise. This was followed by a detailed consultation process with people with MS and occupational therapists. Based on the consultation process the COB-MS was revised.
Results:
This resulting programme takes a three-pronged approach using education, remediation and adaption and is informed by the person-environment-occupation model. The focus of the COB-MS is on managing daily life, employment and community engagement using routines, compensatory strategies, and streaming demands. The structure includes eight sessions. The initial contact is an individual session, followed by five weekly group sessions then two individual sessions.
Conclusion:
This is the first known intervention for cognitive rehabilitation in MS that focuses on rehabilitation through an individualised occupation-based cognitive intervention that is measured through occupational participation.