The effectiveness of a self-management occupational therapy intervention on activity performance in individuals with multiple sclerosis-related fatigue: a randomized-controlled trial

• Published in: International journal of rehabilitation research Vol. 39; no. 3; p. 255
• Main Authors: Kos, Daphne, Duportail, Marijke, Meirte, Jill, Meeus, Mira, D'hooghe, Marie B, Nagels, Guy, Willekens, Barbara, Meurrens, Tom, Ilsbroukx, Stephan, Nijs, Jo
• Format: Journal Article
• Language: English
• Published: England 01.09.2016
• Subjects: Adult; Ergonomics; Fatigue - etiology; Fatigue - rehabilitation; Female; Humans; Male; Multiple Sclerosis - complications; Occupational Therapy; Patient Satisfaction; Pilot Projects; Quality of Life; Relaxation Therapy; Self Care; Single-Blind Method
• ISSN: 1473-5660
• DOI: 10.1097/MRR.0000000000000178

Purpose to evaluate the effectiveness of an individual self-management occupational therapy intervention program (SMOoTh) versus relaxation on the performance of and satisfaction with relevant daily activities in individuals with multiple sclerosis (MS)-related fatigue. in a single-blind randomized-controlled trial, 31 patients with MS (SMOoTh: n=17, relaxation: n=14) were randomly allocated to three individual sessions focusing on pacing, prioritizing, ergonomics, and self-management (SMOoTh) or on stress management and relaxation (relaxation). Outcomes (blind assessor): Canadian Occupational Performance Measure (COPM) (primary), Modified Fatigue Impact Scale, Checklist Individual Strength and Short-Form Health Measure. COPM improved in the SMOoTh and relaxation group after the intervention and 3 months later (COPM performance: F=13.1, P=0.001 and COPM satisfaction: F=10.4, P=0.001); nonsignificant group differences showed a trend in favor of SMOoTh. Modified Fatigue Impact Scale, Checklist Individual Strength, and most of the Short-Form Health Measure subscales did not change. Clinically relevant changes in COPM performance scores were found in 71 and 27% of patients in the SMOoTh versus the relaxation group. Both interventions seem to be feasible approaches to improve performance of and satisfaction with relevant daily activities in people with MS, with a sustained effect after 3 months. Neither program altered change fatigue (impact) or quality of life. Future studies with larger sample sizes are needed.