Effectiveness of energy conservation management on fatigue and participation in multiple sclerosis: A randomized controlled trial

Lyan J. M. Blikman, Jetty van Meeteren*, Jos W. R. Twisk, Fred A. J. de Laat, Vincent de Groot, Heleen Beckerman, Henk J. Stam, Johannes B. J. Bussmann

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

38 Citations (Scopus)


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
Issue number11
Publication statusPublished - Oct 2017

Bibliographical note

The author(s) disclosed receipt of the following
financial support for the research, authorship and/or publication of this article: This study was part of the
Dutch TREFAMS-ACE research programme and
was financially supported by Fonds NutsOhra grant
number (ZonMw 89000005). The funder of the study
had no role in design and conduct of the study, data
collection, data management, data analysis, data
interpretation, preparation and writing of the manuscript, nor in the approval of the manuscript and the
decision to submit the manuscript for publication.

Research programs

  • EMC OR-01


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