***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVES To evaluate a paging system design ed to improve independence in people with memory problems and executive deficits . METHODS After a successful pilot study , a r and omised control trial was conducted involving a crossover design with 143 people aged between 8 and 83 years . All had one or more of the following : memory , planning , attention , or organisation problems . Most had sustained a traumatic head injury or a stroke although a few had developmental learning difficulties or other conditions . The crossover design ensured that some people received a pager after a 2 week baseline whereas others were required to wait for 7 weeks after the baseline before receiving the pager . Participants were assessed at three time periods — namely , at baseline , 7 weeks , and at 14 weeks postbaseline . RESULTS More than 80 % of those who completed the 16 week trial were significantly more successful in carrying out everyday activities ( such as self care , self medication , and keeping appointments ) when using the pager in comparison with the baseline period . For most of these , significant improvement was maintained when they were monitored 7 weeks after returning the pager . CONCLUSIONS This particular paging system significantly reduces everyday failures of memory and planning in people with brain injury A memory-training program previously used effectively upon persons with head-injury ( HI ) was conducted upon eight subjects with multiple sclerosis ( MS ) . The program involved computer-assisted teaching of imagery-based mnemonic strategies for recall of lengthy lists of words , and for associating names with faces . Results were similar to those found in individuals with HI , but the MS subjects learned the strategies quickly , and did not appear to require the lengthy training needed by persons with HI . It was concluded that memory training of those with MS may sometimes only require teaching of mnemonic strategies without extensive practice BACKGROUND Systematic review s have indicated a low level of evidence for the positive effects of neuropsychological and cognitive rehabilitation in multiple sclerosis ( MS ) . How permanent the positive effects are , is unknown . OBJECTIVE The aim of the present study was to evaluate whether short-term neuropsychological rehabilitation has long-term beneficial effects in a nine-month follow-up . METHODS 102 relapsing-remitting MS patients with subjective and objective attentional deficits were r and omized into intervention and control groups . Altogether 78 out of 102 patients ( 76 % ) completed the longitudinal follow-up ( intervention group 83 % , control group 67 % ) . Intervention group received strategy -oriented neuropsychological rehabilitation conducted once a week in 60-minute sessions during thirteen consecutive weeks . The control group received no intervention .  Cognitive deficits , mood , fatigue , impact of disease , and quality of life were evaluated with self-reports at baseline , six months , and one year from baseline . RESULTS The positive effects of neuropsychological  rehabilitation  on perceived cognitive deficits were maintained for nine months . Among a subgroup of patients with moderate to severe attentional deficits , positive rehabilitation outcome was even more evident . CONCLUSION The beneficial effects of strategy -oriented neuropsychological rehabilitation on perceived cognitive deficits in MS may be maintained for at least one year after the beginning of the intervention Summary BACKGROUND : One aim of this project was to investigate the efficacy of a specific training programme for MS patients which also contained compensation strategies and relaxation exercises relevant to everyday life . The other aim was to check the programme 's relevance to everyday life . METHOD : 19 patients , r and omised into two groups , took part in the study . The participants in the treated group completed a specific neurological training programme which began immediately after the basic testing ( visit 1 ) and lasted 4 weeks , with a total of 12 sessions . The monitoring test was done immediately after the training programme ( at visit 2 ) and the follow-up was 3 months later ( visit 3 ) . Both study groups were fully comparable as regards clinical and socio-demographic data and baseline intelligence level . RESULTS : The results of the cognitive training programme were especially evident in the significant improvements in executive functions ( CKV ) and spatial-constructional abilities ( HAWIE-R ) . Comparison between the treated and the control group showed no significant difference in the fatigue values ( MFIS ) . However , when the treated group was examined over the three times of measurements , the symptoms of fatigue had diminished significantly . Regarding memory , comparison of the groups showed no changes ; within the treated group ; however , the verbal ( VLT ) and nonverbal learning and memory ( NVLT ) improved significantly . The results for sustained attention improved in both groups over time . It must be assumed that a learning effect had occurred here . The depression values ( BDI ) also improved in both study groups . The follow-up question naire showed that 60 % ( 6 ) attributed an average to above-average benefit to the training . CONCLUSION : To summarise , it is apparent that MS patients with mild to moderate cognitive impairment are able to profit from even a fairly brief neuropsychological training programme and to integrate much of it into their everyday lives . In view of this , it would seem appropriate to offer such a programme as st and ard , associated with medication . ZusammenfassungHINTERGRUND : Das Ziel dieses Projekts war es einerseits die Effizienz eines spezifischen Trainings , das auch alltagsrelevante Kompensationsstrategien und Entspannungsübungen beinhaltet , bei MS-Patienten zu untersuchen und and ererseits auch dessen Alltagsrelevanz zu überprüfen . METHOD E : 19 PatientInnen , r and omisiert in zwei Gruppen , nahmen an der Untersuchung teil . Die Teilnehmer der Versuchsgruppe absolvierten ein spezifisches neuropsychologisches Trainingsprogramm , das unmittelbar nach der Basistestung ( visit 1 ) begann und 4 Wochen dauerte , wobei insgesamt 12 Sitzungen stattf and en . Unmittelbar nach dem Training erfolgte die Kontrolltestung ( visit 2 ) und nach den darauf folgenden 3 Monaten das Follow-up ( visit 3 ) . Beide Untersuchungsgruppen waren bezüglich ihrer klinischen und soziodemografischen Date n und bezüglich des intellektuellen Ausgangsniveaus gut mitein and er vergleichbar . ERGEBNISSE : Die Erfolge des kognitiven Trainingsprogramms zeigten sich vor allem in den signifikanten Verbesserungen der Exekutivfunktionen ( CKV ) und der räumlich-konstruktiven Fähigkeiten ( HAWIE-R ) . I m Vergleich zwischen Versuchsgruppe und Kontrollgruppe zeigte sich kein signifikanter Unterschied in den Fatigue-Werten ( Ermüdungswerten ) ( MFIS ) . Bei Betrachtung der Therapiegruppe über die Dauer der drei Messzeitpunkte , nahmen die Ermüdungserscheinungen jedoch signifikant ab . Die Änderungen i m Gedächtnisbereich konnten i m Gruppenvergleich nicht nachgewiesen werden , innerhalb der Trainingsgruppe verbesserten sich die verbalen ( VLT ) und nonverbalen Lern- und Gedächtnisleistungen ( NVLT ) jedoch signifikant . Die Daueraufmerksamkeitsleistungen ( Daueraufmerksamkeit ) besserten sich in beiden Gruppen über die Zeit hinweg . Es ist anzunehmen , dass es dabei zu einem Lerneffekt gekommen ist . Die Depressionswerte ( BDI ) verbesserten sich ebenfalls in beiden Untersuchungsgruppen . Der Nachbefragungsbogen ergab , dass 60 % ( 6 ) dem Training einen durchschnittlich bis überdurchschnittlich hohen Gewinn beimaßen . SCHLUSSFOLGERUNG : Zusammenfassend zeigt sich , dass MS-Patienten mit einer leichten bis mittelgradigen kognitiven Störung auch von einem relativ kurzen neuropsychologischen Trainingsprogramms profitieren und vieles davon in ihren Alltag integrieren können . Insofern wäre es sinnvoll , ein derartiges Programm in Kombination mit einer medikamentösen Beh and lung st and ardmäßig anzubieten Background People with multiple sclerosis have problems with memory and attention .  Cognitive rehabilitation is a structured set of therapeutic activities design ed to retrain an individual ’s memory and other cognitive functions . Cognitive rehabilitation may be provided to teach people strategies to cope with these problems , in order to reduce the impact on everyday life . The effectiveness of cognitive rehabilitation for people with multiple sclerosis has not been established . Methods This is a multi-centre , r and omised controlled trial investigating the clinical and cost-effectiveness of a group-based cognitive rehabilitation programme for attention and memory problems for people with multiple sclerosis . Four hundred people with multiple sclerosis will be r and omised from at least four centres . Participants will be eligible if they have memory problems , are 18 to 69 years of age , are able to travel to attend group sessions and give informed consent . Participants will be r and omised in a ratio of 6:5 to the group rehabilitation intervention plus usual care or usual care alone .  Intervention groups will receive 10 weekly sessions of a manualised cognitive rehabilitation programme . The intervention will include both restitution strategies to retrain impaired attention and memory functions and compensation strategies to enable participants to cope with their cognitive problems . All participants will receive a follow-up question naire and an assessment by a research assistant at 6 and 12 months after r and omisation . The primary outcome is the Multiple Sclerosis Impact Scale ( MSIS ) Psychological subscale at 12 months . Secondary outcomes include the Everyday Memory Question naire , General Health Question naire-30 , EQ-5D and a service use question naire from participants , and the Everyday Memory Question naire-relative version and Carer Strain Index from a relative or friend . The primary analysis will be based on intention to treat . A mixed-model regression analysis of the MSIS Psychological subscale at 12 months will be used to estimate the effect of the group cognitive rehabilitation programme . Discussion The study will provide evidence regarding the clinical and cost-effectiveness of a group-based cognitive rehabilitation programme for attention and memory problems in people with multiple sclerosis . Trial registration IS RCT N09697576 . Registered 14 August 2014 Between 40–65 % of multiple sclerosis patients experience cognitive deficits , with processing speed and working memory most commonly affected . This pilot study investigated the effect of computerized cognitive training focused on improving processing speed and working memory .  Participants were r and omized into either an active or a sham training group and engaged in six weeks of training . The active training group improved on a measure of processing speed and attention following cognitive training , and data trended toward significance on measures of other domains . Results provide preliminary evidence that cognitive training with multiple sclerosis patients may produce moderate improvement in select areas of cognitive functioning Recent research on music and brain function has suggested that the temporal pattern structure in music and rhythm can enhance cognitive functions . To further eluci date this question specifically for memory , we investigated if a musical template can enhance verbal learning in patients with multiple sclerosis ( MS ) and if music-assisted learning will also influence short-term , system-level brain plasticity . We measured systems-level brain activity with oscillatory network synchronization during music-assisted learning . Specifically , we measured the spectral power of 128-channel electroencephalogram ( EEG ) in alpha and beta frequency b and s in 54 patients with MS . The study sample was r and omly divided into two groups , either hearing a spoken or a musical ( sung ) presentation of Rey ’s auditory verbal learning test . We defined the “ learning-related synchronization ” ( LRS ) as the percent change in EEG spectral power from the first time the word was presented to the average of the subsequent word encoding trials . LRS differed significantly between the music and the spoken conditions in low alpha and upper beta b and s. Patients in the music condition showed overall better word memory and better word order memory and stronger bilateral frontal alpha LRS than patients in the spoken condition . The evidence suggests that a musical mnemonic recruits stronger oscillatory network synchronization in prefrontal areas in MS patients during word learning . It is suggested that the temporal structure implicit in musical stimuli enhances “ deep encoding ” during verbal learning and sharpens the timing of neural dynamics in brain networks de grade d by demyelination in MS Background : There is preliminary evidence on the positive effects of neuropsychological rehabilitation on cognition in multiple sclerosis ( MS ) , but the generalisability of the findings is limited by method ological problems . Objective : The aim of the present study was to determine the effects of strategy -oriented neuropsychological rehabilitation on MS . Methods : A total of 102 relapsing – remitting MS patients with subjective and objective attentional deficits were r and omised into an intervention and a control group .  Neuropsychological assessment  s were performed at baseline , at three months immediately after the intervention , and at six months . Patients in the intervention group received neuropsychological rehabilitation once a week in 60-minute sessions for 13 consecutive weeks . The control group received no intervention . Results : Neuropsychological rehabilitation including computer-based attention and working memory retraining , psychoeducation , strategy learning and psychological support did not improve cognitive performance but had a positive effect on perceived cognitive deficits . The intervention group perceived significantly fewer deficits than the control group both immediately after the intervention and at six months . The personal rehabilitation goals were also well achieved . Conclusions : Strategy -oriented neuropsychological rehabilitation did not improve cognitive performance but reduced perceived cognitive deficits in MS We conducted a retrospective case-control study of falls over a four year period on a 30 bed neurorehabilitation unit at the Burke Rehabilitation Hospital to characterize the nature of falls and identify factors associated with falling . The most common diagnoses treated on the unit were traumatic spinal cord injury , brain injury , and multiple sclerosis ; stroke patients are treated on another service . Falls represented 72 percent of all incident reports made to the Nursing Office during the study period . One hundred seventeen ( 117 ) falls occurred in 82 patients during a time when the unit census was 28,622 patient days , yielding 
    Output:
    
OBJECTIVES To determine whether people with MS who received memory rehabilitation  showed : 1 .
better outcomes in their memory functions compared to those given no treatment or receiving a placebo control ; and 2 .
These findings showed that the intervention group performed significantly better than the control group .
However , a sensitivity analysis of high- versus low-risk studies suggested that while quality of the trials did not affect most outcomes , differences were seen in the objective memory outcomes ( both at immediate and long term ) and quality of life ( immediate ) outcome , with studies with higher risk of bias inflating the overall effect size estimates for these outcomes , and the test of overall effect changing from being statistically significant to not significant when studies at high risk of bias were excluded .
This suggests that lower- quality studies may have positively influenced the outcomes .
There is some evidence to support the effectiveness of  memory rehabilitation  on memory function , as well as on quality of life .
However , the evidence is limited and does not extend to subjective reports of memory functioning or mood .