The data provide the first evidence that vestibular stimulation may help improve outcome in a low awareness state, although further studies are needed to replicate effect and determine longer-term benefit.
Objective: To assess the clinical and cost-effectiveness of cognitive rehabilitation for attention and memory problems in people with multiple sclerosis. Design: Multicentre, pragmatic, randomized controlled trial. Setting: Community Participants: People with multiple sclerosis aged 18–69 years, who reported cognitive problems in daily life and had cognitive problems on standardized assessment. Interventions: A group cognitive rehabilitation programme delivered in 10 weekly sessions in comparison with usual care. Main measures: The primary outcome was the Multiple Sclerosis Impact Scale Psychological subscale at 12 months after randomization. Secondary outcomes included measures of everyday memory problems, mood, fatigue, cognitive abilities and employment at 6 and 12 months after randomization. Results: In all, 245 participants were allocated to cognitive rehabilitation and 204 to usual care. Mean Multiple Sclerosis Impact Scale Psychological at 12 months was 22.2 (SD = 6.1) for cognitive rehabilitation and 23.4 (SD = 6.0) for usual care group; adjusted difference −0.6, 95% confidence interval (CI) = −1.5 to 0.3, P = 0.20. No differences were observed in cognitive abilities, fatigue or employment. There were small differences in favour of cognitive rehabilitation for the Multiple Sclerosis Impact Scale Psychological at 6 months and everyday memory and mood at 6 and 12 months. There was no evidence of an effect on costs (−£808; 95% CI = −£2248 to £632) or on quality-adjusted life year gain (0.00; 95% CI = −0.01 to 0.02). Conclusion: This rehabilitation programme had no long-term benefits on the impact of multiple sclerosis on quality of life, but there was some evidence of an effect on everyday memory problems and mood.
The IDS-2 is a broad developmental assessment for 5-to 20-year-olds containing subtests across six domains: Intelligence, Executive functions, Psychomotor skills, Social-emotional skills, Scholastic skills, and Motivation and attitude. The original Intelligence and Development Scales (IDS;Grob, et al., 2009) was designed for children aged 5-10 years. The IDS-2 (Grob & Hagmann-von Arx, 2018) expanded the age range and the domains included in the test battery, and has been adapted and standardised in many countries including Germany, Italy, the Netherlands and Poland.The UK standardisation (IDS-2; Grob et al., 2021) involved testing 1367 children and adolescents across the UK. The sample was stratified according to ethnicity and highest level of maternal education, with appropriate weighting to achieve a representative match to the 2011 UK Census data. The IDS-2 is designed to be used in a modular fashion, selecting different domains depending on the purpose and focus of the assessment. In this article, we outline the Psychomotor skills domain of the IDS-2.
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