The Efficacy of the Speed of Processing Training Program in Improving Functional Outcome: From Restoration to Generalization

Abstract

Objective: To examine the efficacy of Speed of Processing Training (SOPT) in improving everyday functional outcomes in persons with multiple sclerosis (MS).

Design: Randomized controlled trial.

Setting: A nonprofit rehabilitation research institution and the community.

Participants: In total, 60 participants with MS with impaired processing speed were randomly assigned to SOPT (n=33) or an active control group (n=27).

Intervention: SOPT, a restorative computerized cognitive intervention involving 10 treatment sessions consisting of visual tasks designed to improve speed and accuracy of information processing MAIN OUTCOME MEASURES: Outcomes included performance on the Timed Instrumental Activities of Daily Living (TIADL) and self-report of functional behavior, quality of life, and affect.

Results: The treatment group showed improvement in the total TIADL score and 2 subtests compared with the active control group. Participants in the treatment group who demonstrated improved cognitive performance after the intervention also showed improved performance on one TIADL subtest. Quality of life, affective symptomatology, and self-reported functional status were not changed after the intervention.

Conclusions: Improvement in underlying cognitive or perceptual deficits is thought to promote recovery and everyday performance as per the restorative approach to cognitive rehabilitation. However, this study showed only selected improvements in everyday functional outcomes for persons with MS.

Trial registration: ClinicalTrials.gov NCT02301260.

Keywords: Activities of daily living; Clinical trial; Cognition; Cognitive training; Multiple sclerosis; Quality of life; Rehabilitation; Treatment outcome.