Salome Emmanuel & Alex Mulhern

Managing Daily Life with Cognitive Challenges for Persons with Multiple Sclerosis: Protocol Development

Authors: Alex Mulhern, Salome Emmanuel, Dr. Susan Forwell, Denise Kendrick & Nancy Forseth

Background. Approximately half of all persons with multiple sclerosis (MS) experience cognitive challenges. Despite growing evidence about the impact on daily life, there are few cognitive interventions leaving individuals with MS with limited options. To date, there is no individualized intervention manual for the treatment of cognitive dysfunction in persons with MS that targets education, specific cognitive domains impairments, and challenges in daily function. Objectives. (1) To develop an individualized intervention manual for cognitive dysfunction in MS. (2) To test the clinical utility of the individualized cognitive intervention manual with a group of experienced clinicians. Method. The development phase involved an extensive literature review from which interventions were selected and included in the program. Interventions to support challenges with daily function emerged from grey literature and clinical experience. These results were compiled into an easy to use manual for both persons with MS and clinicians. The preliminary testing phase of the manual and program involved occupational therapists with experience working with persons with MS to review the manual and respond to a questionnaire regarding the clinical utility. Interviews were conducted to provide additional feedback on the manual usefulness and feasibility. Results. An individualized cognitive intervention manual for persons with MS was created that addresses both specific cognitive impairments and challenges in daily function. Feedback from participants was used to refine the manual prior to pilot testing the manual. It is expected that the intervention will be clinically useful for the treatment of cognitive dysfunction in persons with MS. Conclusion. A individualized cognitive intervention manual should lead to an increase in knowledge and strategies to manage cognitive challenges in daily life and lead to satisfaction in daily function and quality of life for persons with MS.