Comparing the Effectiveness of Computer-Based, Manual-Based, and Combined Cognitive Rehabilitation on Cognitive Functions in Relapsing-Remitting Multiple Sclerosis Patients

Introduction: this study aimed to compare the effectiveness of computer-based, manualbased, and combined cognitive rehabilitation to improve cognitive functions among patients with relapsing-remitting multiple sclerosis (rrms). methods: this was a quasi-experimental study with a pre-test-post-test, and a 2-month followup, as well as a control group design. sixty female patients with rrms were selected by convenience sampling technique. then they were randomly assigned into three experimental groups (computer-based, manual-based, and combined cognitive rehabilitation, each group including 12 patients), a placebo group (12 patients), and a control group (12 patients). the interventions were conducted in 21 sessions for the experimental groups for 5 months. the placebo group received physical rehabilitation intervention, and the control group received no intervention. the study participants were assessed by psychiatric-neurological profile, mini- mental state examination, kurtzke expanded disability status scale, stroop color and word test, wisconsin card sorting test, and paced auditory serial addition test. the obtained data were analyzed by repeated-measures multivariate analysis of variance in spss. results: the effect of group factor was not significant (η²=0.129), but the effect of time (η²=0.884) and interaction effect of time and group (η²=0.295) were statistically significant (p<0.05). there was no significant difference between the effects of all three rehabilitation interventions (p>0.05). in the post-test totally and in follow-up partially, all comparisons among three experimental groups with control and placebo groups were statistically significant (p<0.05). conclusion: cognitive rehabilitation was effective in improving cognitive functions in patients with rrms. thus, these interventions are recommended for application, along with other treatment protocols to treat rrms in clinical settings