Efficacy of an energy conservation course for persons with multiple sclerosis. Effects of an energy conservation course on fatigue impact for persons with progressive multiple sclerosis. Evaluation of the effectiveness of professionally guided self-care for people with multiple sclerosis living in the community: a randomized controlled trial.
To evaluate the efficacy of an energy conservation course on fatigue impact, self-efficacy, and quality of life (QOL) for persons with multiple sclerosis (MS).
                Repeated measures with control and experimental interventions conducted during a 19-week study.
                Community-based treatment center.
                A convenience sample of 54 individuals from 79 community-dwelling volunteers with fatigue secondary to MS.
                A 6-session, 2-hr/wk energy conservation course taught by occupational therapists for groups of 8 to 10 participants.
                Fatigue Impact Scale (self-report measure of fatigue impact on cognitive, physical, social functions), Self-Efficacy Gauge (self-report measure of confidence in ability to perform specific behaviors), and Medical Outcomes Study Short-Form Health Survey (QOL measure).
                Participants reported, as predicted, significantly less fatigue impact, increased self-efficacy, and improved QOL (ie, 3 of 4 subscales expected to improve). There were no significant differences, as predicted, in any of the dependent variables after the control (ie, support group) and no intervention periods.
                Results provide strong evidence for the efficacy of this energy conservation course for persons with MS. Fatigue is a common, troublesome symptom for persons with multiple sclerosis. This study evaluated the effects of an energy conservation course on fatigue impact for persons with multiple sclerosis whose symptoms cause moderate to severe disability.
                Thirty-seven persons with progressive multiple sclerosis participated in an 8-week experimental energy conservation course treatment and an 8-week control period of traditional treatment using a crossover design. The Fatigue Impact Scale (FIS) was used to assess fatigue impact before and after the experimental and control periods, and 8 weeks post-energy conservation course.
                After participation in the energy conservation course, the average FIS total score and physical, cognitive, and psychosocial subscale scores decreased significantly, whereas the total and subscale scores did not change significantly during the control period. Additionally, decreased fatigue impact was maintained 8 weeks after course completion for evaluated participants.
                This study provides evidence that this energy conservation course can be a beneficial intervention for persons with progressive multiple sclerosis. The aim of the study was to assess the efficacy of a patient-focused professionally guided self-care programme for the management of multiple sclerosis (MS) in the community.
                This was a single-blind randomized controlled trial.
                The study was conducted with people with MS living in the community.
                Two hundred and seventy-eight people with MS were invited to take part in the study. One hundred and eighty-nine people consented to take part (68%). Of these 183 began the study and 169 (92.3%) completed it. Seventy-three individuals were in the intervention group and 96 were in the control group.
                The intervention comprised discussion of self-care based on client priorities, using an information booklet about self-care.
                These included the Barthel Index, a measure of mobility, the SF-36, and the Standard Day Dependency Record (SDDR) which measures the need for assistance with daily activities. Assessments were conducted at baseline and again six months later.
                Changes in health status were small. However, at follow-up the intervention group had better SF-36 health scores, in mental health (p = 0.04), and vitality (p = 0.05) and considered help with daily activities to be less essential, as measured by the SDDR (p = 0.04), than the control group. Participants in the intervention group had maintained levels of independence at follow-up (p = 0.62) while the control group showed a significant decrease in independence (p= 0.001).
                This intervention could be a useful aid for health professionals who are supporting people with MS living in the community.
On basis of this review no conclusions can be stated whether or not occupational therapy improves outcomes in MS patients.The lack of (randomized controlled) efficacy studies in most intervention categories of occupational therapy demonstrates an urgent need for future research in occupational therapy for multiple sclerosis. Initially, a survey of occupational therapy practice for MS patients, including the characteristics and needs of these patients, is necessary to develop a research agenda for efficacy studies.