Effectiveness of fatigue management interventions in reducing severity and impact of fatigue in people with progressive multiple sclerosis: a systematic review

Scott Rooney; Fiona Moffat; Les Wood; Lorna Paul

doi:10.7224/1537-2073.2018-019

Effectiveness of fatigue management interventions in reducing severity and impact of fatigue in people with progressive multiple sclerosis: a systematic review

Scott Rooney^*, Fiona Moffat, Les Wood, Lorna Paul

^*Corresponding author for this work

Research output: Contribution to journal › Article

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Abstract

Background: Rehabilitation interventions are recommended to manage multiple sclerosis (MS)-related fatigue. However, existing research has largely been generalized to those with relapsing-remitting MS, making it difficult to determine the effectiveness of these interventions in people with progressive MS. Therefore, this study aimed to systematically review the evidence related to the effectiveness of fatigue management interventions in reducing the severity and impact of fatigue in people with progressive MS. Methods: Six electronic databases (CINAHL, Cochrane Library, MEDLINE, PEDro, ProQuest, and Web of Science Core Collections) were searched for relevant articles up until November 2017. Randomized controlled trials and quasi-experimental studies that examined the effects of exercise, behavioral interventions, and rehabilitation on fatigue in people with progressive MS using self-reported fatigue outcome measures were included in this review. Results: Eight exercise, two rehabilitation, and two behavioral interventions were investigated in the 13 articles included in this review. Heterogeneous effects were reported between studies, with only two exercise, one behavioral, and two rehabilitation interventions recording significant improvements in postintervention fatigue severity or impact. However, most studies were underpowered, only two used fatigue as the primary outcome, and only one specifically recruited participants with predefined levels of fatigue. Conclusions: Evidence from this review is inconclusive regarding the effectiveness of nonpharmacologic interventions in reducing the severity and impact of fatigue in progressive MS populations. Adequately powered randomized controlled trials are required to evaluate fatigue management interventions in people with progressive MS experiencing high levels of fatigue and using fatigue as the primary outcome.

Original language	English
Pages (from-to)	35-46
Number of pages	12
Journal	International Journal of MS Care
Volume	21
Issue number	1
DOIs	https://doi.org/10.7224/1537-2073.2018-019
Publication status	Published - 1 Jan 2019

Keywords

multiple sclerosis
fatigue management
systematic review

Documents and Links

10.7224/1537-2073.2018-019

Rooney, S. et al (2019) Effectiveness of fatigue management interventions in reducing the severity and impact of fatigue in people with progressive Multiple Sclerosis: a systematic review
Copyright © 2019 The Consortium of Multiple Sclerosis Centers. This is the post-peer review, pre-copy edited version of the article published in International Journal of MS Care and may differ slightly from the final published version of the work. The final published version of the article is available at the DOI link below. The journal is available at: www.ijmsc.org
Accepted author manuscript, 862 KB

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Lorna Paul

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Physiotherapy - Professor

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Rooney, S., Moffat, F., Wood, L., & Paul, L. (2019). Effectiveness of fatigue management interventions in reducing severity and impact of fatigue in people with progressive multiple sclerosis: a systematic review. International Journal of MS Care, 21(1), 35-46. https://doi.org/10.7224/1537-2073.2018-019

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title = "Effectiveness of fatigue management interventions in reducing severity and impact of fatigue in people with progressive multiple sclerosis: a systematic review",

abstract = "Background: Rehabilitation interventions are recommended to manage multiple sclerosis (MS)-related fatigue. However, existing research has largely been generalized to those with relapsing-remitting MS, making it difficult to determine the effectiveness of these interventions in people with progressive MS. Therefore, this study aimed to systematically review the evidence related to the effectiveness of fatigue management interventions in reducing the severity and impact of fatigue in people with progressive MS. Methods: Six electronic databases (CINAHL, Cochrane Library, MEDLINE, PEDro, ProQuest, and Web of Science Core Collections) were searched for relevant articles up until November 2017. Randomized controlled trials and quasi-experimental studies that examined the effects of exercise, behavioral interventions, and rehabilitation on fatigue in people with progressive MS using self-reported fatigue outcome measures were included in this review. Results: Eight exercise, two rehabilitation, and two behavioral interventions were investigated in the 13 articles included in this review. Heterogeneous effects were reported between studies, with only two exercise, one behavioral, and two rehabilitation interventions recording significant improvements in postintervention fatigue severity or impact. However, most studies were underpowered, only two used fatigue as the primary outcome, and only one specifically recruited participants with predefined levels of fatigue. Conclusions: Evidence from this review is inconclusive regarding the effectiveness of nonpharmacologic interventions in reducing the severity and impact of fatigue in progressive MS populations. Adequately powered randomized controlled trials are required to evaluate fatigue management interventions in people with progressive MS experiencing high levels of fatigue and using fatigue as the primary outcome.",

keywords = "multiple sclerosis, fatigue management , systematic review",

author = "Scott Rooney and Fiona Moffat and Les Wood and Lorna Paul",

note = "Acceptance in SAN Publisher policy not in Sherpa. File is available to download from publisher website - made open (no embargo) and sent note to publisher. ET 18/4/19 Pub date: earliest date is 1-1-19 on journal webpage. ET 30/10/19 Applied 'no exception' re access date. ET 14/1/20 Pub date: we used 1-1-19 as this is on the publisher website. Note it also gives Jan/Feb as the issue date and this is the pattern for this journal (i.e. the issue appears to be published on the first day of the first month looking at other issues). ET 13/7/20 ",

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AU - Wood, Les

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N1 - Acceptance in SAN Publisher policy not in Sherpa. File is available to download from publisher website - made open (no embargo) and sent note to publisher. ET 18/4/19 Pub date: earliest date is 1-1-19 on journal webpage. ET 30/10/19 Applied 'no exception' re access date. ET 14/1/20 Pub date: we used 1-1-19 as this is on the publisher website. Note it also gives Jan/Feb as the issue date and this is the pattern for this journal (i.e. the issue appears to be published on the first day of the first month looking at other issues). ET 13/7/20

PY - 2019/1/1

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N2 - Background: Rehabilitation interventions are recommended to manage multiple sclerosis (MS)-related fatigue. However, existing research has largely been generalized to those with relapsing-remitting MS, making it difficult to determine the effectiveness of these interventions in people with progressive MS. Therefore, this study aimed to systematically review the evidence related to the effectiveness of fatigue management interventions in reducing the severity and impact of fatigue in people with progressive MS. Methods: Six electronic databases (CINAHL, Cochrane Library, MEDLINE, PEDro, ProQuest, and Web of Science Core Collections) were searched for relevant articles up until November 2017. Randomized controlled trials and quasi-experimental studies that examined the effects of exercise, behavioral interventions, and rehabilitation on fatigue in people with progressive MS using self-reported fatigue outcome measures were included in this review. Results: Eight exercise, two rehabilitation, and two behavioral interventions were investigated in the 13 articles included in this review. Heterogeneous effects were reported between studies, with only two exercise, one behavioral, and two rehabilitation interventions recording significant improvements in postintervention fatigue severity or impact. However, most studies were underpowered, only two used fatigue as the primary outcome, and only one specifically recruited participants with predefined levels of fatigue. Conclusions: Evidence from this review is inconclusive regarding the effectiveness of nonpharmacologic interventions in reducing the severity and impact of fatigue in progressive MS populations. Adequately powered randomized controlled trials are required to evaluate fatigue management interventions in people with progressive MS experiencing high levels of fatigue and using fatigue as the primary outcome.

AB - Background: Rehabilitation interventions are recommended to manage multiple sclerosis (MS)-related fatigue. However, existing research has largely been generalized to those with relapsing-remitting MS, making it difficult to determine the effectiveness of these interventions in people with progressive MS. Therefore, this study aimed to systematically review the evidence related to the effectiveness of fatigue management interventions in reducing the severity and impact of fatigue in people with progressive MS. Methods: Six electronic databases (CINAHL, Cochrane Library, MEDLINE, PEDro, ProQuest, and Web of Science Core Collections) were searched for relevant articles up until November 2017. Randomized controlled trials and quasi-experimental studies that examined the effects of exercise, behavioral interventions, and rehabilitation on fatigue in people with progressive MS using self-reported fatigue outcome measures were included in this review. Results: Eight exercise, two rehabilitation, and two behavioral interventions were investigated in the 13 articles included in this review. Heterogeneous effects were reported between studies, with only two exercise, one behavioral, and two rehabilitation interventions recording significant improvements in postintervention fatigue severity or impact. However, most studies were underpowered, only two used fatigue as the primary outcome, and only one specifically recruited participants with predefined levels of fatigue. Conclusions: Evidence from this review is inconclusive regarding the effectiveness of nonpharmacologic interventions in reducing the severity and impact of fatigue in progressive MS populations. Adequately powered randomized controlled trials are required to evaluate fatigue management interventions in people with progressive MS experiencing high levels of fatigue and using fatigue as the primary outcome.

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KW - fatigue management

KW - systematic review

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SN - 1537-2073

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