A recent study published in The Lancet Neurology investigated whether a combination of cognitive rehabilitation and exercise could improve processing speed in patients with progressive multiple sclerosis (MS). However, the findings from the CogEx trial (NCT03679468) did not support the central hypothesis that this approach would have a synergistically beneficial effect.
The trial included 311 patients with progressive MS, who were randomly assigned to different treatment arms: cognitive rehabilitation plus exercise, cognitive rehabilitation plus sham exercise, exercise plus sham cognitive rehabilitation, or sham exercise plus sham cognitive rehabilitation. After 12 weeks of intervention, there were no significant differences in processing speed between the groups.
Lead author Anthony Feinstein, MPhil, PhD, FRCP, noted that the primary outcome measure did not differ across the treatment arms, partly due to the unexpected improvement observed in the sham exercise group. The stretching and balance exercises provided to this group led to an unexpected positive outcome in the 6-minute walk test, a secondary outcome measure.
These results challenge the conventional belief in the synergistic benefits of cognitive rehabilitation and exercise and highlight the need for reevaluation and more nuanced approaches for patients with progressive MS. The study also underscores the complexity of addressing cognitive decline in MS and emphasizes the importance of tailored interventions.
FAQ:
Q: What was the aim of the CogEx trial?
A: The trial aimed to assess whether a combination of cognitive rehabilitation and exercise could improve processing speed in patients with progressive MS.
Q: How many patients were enrolled in the trial?
A: A total of 311 patients with progressive MS participated in the trial.
Q: Were there any significant differences in processing speed between the treatment groups?
A: No, there were no significant differences in processing speed between the different treatment arms.
Q: What unexpected positive outcome was observed in the study?
A: The sham exercise group showed an unexpected improvement in the 6-minute walk test, a secondary outcome measure.
Q: What are the implications of these findings?
A: The study challenges the conventional belief in the synergistic benefits of cognitive rehabilitation and exercise and highlights the need for reevaluation and more tailored approaches in the treatment of cognitive decline in MS.