Goal attainment in cognitive rehabilitation in MS patients

Abstract

The aim of the study was to investigate the predictive value of important disease-related variables on goal attainment in cognitive rehabilitation in multiple sclerosis (MS). The possible predictive value of executive functions, neurological disability, depression and general cognitive ability was assessed, employing Goal Attainment Scaling (GAS). Fifty-seven patients with MS were assessed for executive functions, neurological disability, depression and general cognitive ability, and guided through the process of formulating GAS-goals for coping with cognitive challenges in everyday life during a four week in-patient cognitive rehabilitation programme. GAS-goal attainment was scored during biweekly follow-up calls in the first three months post-discharge from the rehabilitation centre, and finally at seven months after the start of the rehabilitation. Consistent with the first study hypothesis MS patients succeeded in formulating and achieving GAS goals for coping with cognitive problems in everyday life. The patients were able to maintain a satisfactory level of goal attainment from the first measurement point after six weeks to seven months after the start of the rehabilitation. However, contrary to the second hypothesis, attainment of GAS goals was not predicted by executive functions. Neither was it predicted by neurological disability, depression or general cognitive ability. The findings suggest that GAS may be a practical and robust method in cognitive rehabilitation in MS patients, regardless of important disease-related characteristics.

Keywords:

• Multiple sclerosis
• Goal attainment
• Cognitive rehabilitation
• Executive functions

We would like to thank all the patients who participated in the study. We also would like to thank the following colleagues for their contribution to data collection: Inger Grethe Løyning, Kari-Ann Nevjen and Tove Rude Johannessen. The study received financial support from the MS Society of Norway.