Lyan Jm Blikman1, Jetty van Meeteren2, Jos Wr Twisk3, Fred Aj de Laat4, Vincent de Groot5, Heleen Beckerman5, Henk J Stam1, Johannes Bj Bussmann1. 1. Department of Rehabilitation Medicine, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands. 2. Department of Rehabilitation Medicine, Erasmus MC - University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands. 3. Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands. 4. Libra Rehabilitation Medicine and Audiology, Tilburg, The Netherlands. 5. Department of Rehabilitation Medicine, VUmc MS Center and EMGO Insitute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
Abstract
BACKGROUND:Fatigue is a frequently reported and disabling symptom in multiple sclerosis (MS). OBJECTIVE: To investigate the effectiveness of an individual energy conservation management (ECM) intervention on fatigue and participation in persons with primary MS-related fatigue. METHODS: A total of 86 severely fatigued and ambulatory adults with a definite diagnosis of MS were randomized in a single-blind, two-parallel-arm randomized clinical trial to the ECM group or the information-only control group in outpatient rehabilitation departments. Blinded assessments were carried out at baseline and at 8, 16, 26 and 52 weeks after randomization. Primary outcomes were fatigue (fatigue subscale of Checklist Individual Strength - CIS20r) and participation (Impact on Participation and Autonomy scale - IPA). RESULTS: Modified intention-to-treat analysis was based on 76 randomized patients (ECM, n = 36; MS nurse, n=40). No significant ECM effects were found for fatigue (overall difference CIS20r between the groups = -0.81; 95% confidence interval (CI), -3.71 to 2.11) or for four out of five IPA domains. An overall unfavourable effect was found in the ECM group for the IPA domain social relations (difference between the groups = 0.19; 95% CI, 0.03 to 0.35). CONCLUSION: The individual ECM format used in this study did not reduce MS-related fatigue and restrictions in participation more than an information-only control condition.
RCT Entities:
BACKGROUND:Fatigue is a frequently reported and disabling symptom in multiple sclerosis (MS). OBJECTIVE: To investigate the effectiveness of an individual energy conservation management (ECM) intervention on fatigue and participation in persons with primary MS-related fatigue. METHODS: A total of 86 severely fatigued and ambulatory adults with a definite diagnosis of MS were randomized in a single-blind, two-parallel-arm randomized clinical trial to the ECM group or the information-only control group in outpatient rehabilitation departments. Blinded assessments were carried out at baseline and at 8, 16, 26 and 52 weeks after randomization. Primary outcomes were fatigue (fatigue subscale of Checklist Individual Strength - CIS20r) and participation (Impact on Participation and Autonomy scale - IPA). RESULTS: Modified intention-to-treat analysis was based on 76 randomized patients (ECM, n = 36; MS nurse, n=40). No significant ECM effects were found for fatigue (overall difference CIS20r between the groups = -0.81; 95% confidence interval (CI), -3.71 to 2.11) or for four out of five IPA domains. An overall unfavourable effect was found in the ECM group for the IPA domain social relations (difference between the groups = 0.19; 95% CI, 0.03 to 0.35). CONCLUSION: The individual ECM format used in this study did not reduce MS-related fatigue and restrictions in participation more than an information-only control condition.
Entities:
Keywords:
Energy conservation; fatigue; fatigue management; multiple sclerosis; participation; randomized controlled trial; rehabilitation medicine
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