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.

Original languageEnglish
Pages (from-to)1527-1541
Number of pages15
JournalMultiple Sclerosis Journal
Volume23
Issue number11
DOIs
Publication statusPublished - 1 Oct 2017

Cite this

@article{67284f9bc53042ada7496bfd901bf1e5,
title = "Effectiveness of energy conservation management on fatigue and participation in multiple sclerosis: A randomized controlled trial",
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.",
keywords = "Energy conservation, Fatigue, Fatigue management, Multiple sclerosis, Participation, Randomized controlled trial, Rehabilitation medicine",
author = "{TREFAMS-ACE study group} and Blikman, {Lyan J.M.} and {van Meeteren}, Jetty and Twisk, {Jos W.R.} and {de Laat}, {Fred A.J.} and {de Groot}, Vincent and Heleen Beckerman and Stam, {Henk J.} and Bussmann, {Johannes B.J.} and A. Malekzadeh and {Van Den Akker}, {L. E.} and M. Looijmans and Sanches, {S. A.} and J. Dekker and Collette, {E. H.} and {Van Oosten}, {B. W.} and Teunissen, {C. E.} and Blankenstein, {M. A.} and Eijssen, {I. C.J.M.} and M. Rietberg and M. Heine and O. Verschuren and G. Kwakkel and Visser-Meily, {J. M.A.} and {Van De Port}, {I. G.L.} and E. Lindeman and Hintzen, {R. Q.} and Hacking, {H. G.A.} and Hoogervorst, {E. L.} and Frequin, {S. T.F.M.} and H. Knoop and {De Jong}, {B. A.} and G. Bleijenberg and Verhulsdonck, {M. C.} and {van Munster}, {E. Th L.} and Oosterwijk, {C. J.} and Aarts, {G. J.}",
year = "2017",
month = "10",
day = "1",
doi = "10.1177/1352458517702751",
language = "English",
volume = "23",
pages = "1527--1541",
journal = "Multiple Sclerosis Journal",
issn = "1352-4585",
publisher = "SAGE Publications",
number = "11",

}

Effectiveness of energy conservation management on fatigue and participation in multiple sclerosis : A randomized controlled trial. / TREFAMS-ACE study group.

In: Multiple Sclerosis Journal, Vol. 23, No. 11, 01.10.2017, p. 1527-1541.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Effectiveness of energy conservation management on fatigue and participation in multiple sclerosis

T2 - A randomized controlled trial

AU - TREFAMS-ACE study group

AU - Blikman, Lyan J.M.

AU - van Meeteren, Jetty

AU - Twisk, Jos W.R.

AU - de Laat, Fred A.J.

AU - de Groot, Vincent

AU - Beckerman, Heleen

AU - Stam, Henk J.

AU - Bussmann, Johannes B.J.

AU - Malekzadeh, A.

AU - Van Den Akker, L. E.

AU - Looijmans, M.

AU - Sanches, S. A.

AU - Dekker, J.

AU - Collette, E. H.

AU - Van Oosten, B. W.

AU - Teunissen, C. E.

AU - Blankenstein, M. A.

AU - Eijssen, I. C.J.M.

AU - Rietberg, M.

AU - Heine, M.

AU - Verschuren, O.

AU - Kwakkel, G.

AU - Visser-Meily, J. M.A.

AU - Van De Port, I. G.L.

AU - Lindeman, E.

AU - Hintzen, R. Q.

AU - Hacking, H. G.A.

AU - Hoogervorst, E. L.

AU - Frequin, S. T.F.M.

AU - Knoop, H.

AU - De Jong, B. A.

AU - Bleijenberg, G.

AU - Verhulsdonck, M. C.

AU - van Munster, E. Th L.

AU - Oosterwijk, C. J.

AU - Aarts, G. J.

PY - 2017/10/1

Y1 - 2017/10/1

N2 - 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.

AB - 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.

KW - Energy conservation

KW - Fatigue

KW - Fatigue management

KW - Multiple sclerosis

KW - Participation

KW - Randomized controlled trial

KW - Rehabilitation medicine

UR - http://www.scopus.com/inward/record.url?scp=85043394080&partnerID=8YFLogxK

U2 - 10.1177/1352458517702751

DO - 10.1177/1352458517702751

M3 - Article

VL - 23

SP - 1527

EP - 1541

JO - Multiple Sclerosis Journal

JF - Multiple Sclerosis Journal

SN - 1352-4585

IS - 11

ER -