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

doi:10.1177/1352458517702751

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

Rehabilitation Medicine

Research output: Contribution to journal › Article › Academic › peer-review

36 Citations (Scopus)

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 language	English
Pages (from-to)	1527-1541
Number of pages	15
Journal	Multiple Sclerosis
Volume	23
Issue number	11
DOIs	https://doi.org/10.1177/1352458517702751
Publication status	Published - Oct 2017

Bibliographical note

Funding
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.

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http://hdl.handle.net/1765/102200

Cite this

@article{61d12803601e44019d8e04f877b0afc5,

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.",

author = "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.}",

note = "Funding 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.",

year = "2017",

month = oct,

doi = "10.1177/1352458517702751",

language = "English",

volume = "23",

pages = "1527--1541",

journal = "Multiple Sclerosis",

issn = "1352-4585",

publisher = "SAGE Publications Ltd",

number = "11",

}

TY - JOUR

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

T2 - A randomized controlled trial

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.

N1 - Funding 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.

PY - 2017/10

Y1 - 2017/10

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.

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U2 - 10.1177/1352458517702751

DO - 10.1177/1352458517702751

M3 - Article

C2 - 28528565

SN - 1352-4585

VL - 23

SP - 1527

EP - 1541

JO - Multiple Sclerosis

JF - Multiple Sclerosis

IS - 11

ER -

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

Abstract

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