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چکیده
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Background: Cognitive and physical challenges are prevalent and co-occuring, yet incompletely managed in people with multiple sclerosis (MS). Purpose: This study compared the effects of six months of home-based neuro-functional training (HBNFT) and home-based resistance training (HBRT) on cognitive and motor functions in MS patients with cognitive impairment (CI), Methods: The trial included 93 women with MS and cognitive impairment who were randomly assigned into one of three conditions: HBNFT, HBRT, or control. The conditions involved one month of center-based training followed by thrice-weekly home-based training for six months. Cognitive functions (processing speed, learning and memory) were assessed before and after the protocol. Physical functions (static and dynamic balance, walking speed, reaction time, walking ability, lower limb function, upper and lower body strength) were assessed at baseline and months 1, 2, 3, 4, 5 and 6. Two-way analysis of variance (time*group interaction) were used for between-group comparisons. Statistical analyzes were performed based on the intention-to-treat (ITT) with missing data handled by multiple imputation method. Result: Both intervention conditions significantly improved learning (P≤0.014), walking speed (P≤0.013), reaction time (P≤0.001), lower limb function (P≤0.010), walking ability (P≤0.018), lower (P≤0.001) and upper body strength (P≤0.003), and fatigue (P ≤ 0.005) compared with the control. HBNFT significantly improved processing speed (P = 0.042), memory (P = 0.043), static balance (P = 0.023) compared with the control group. Conclusion: This study suggests that HBNFT is a safe and effective choice for improving motoric-cognitive functions in MS patients with CI. This study further underscores the benefits of home-based interventions for managing cognitive and motor impairments in the MS population.
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