Fatigue is a pervasive symptom of chronic disease that often interferes with occupational performance. Our objective was to describe what is known about energy management education and occupation-related outcomes in adults with chronic diseases.
Methods
Seven electronic databases were searched for relevant literature published before August 2019. Eligible articles were full-text, available in English, and studied energy management education in adults with a chronic disease. The first author assessed article eligibility with validation from a second reviewer, extracted characteristics of included studies, and described them using descriptive statistics. A narrative synthesis of findings was conducted for each chronic disease population.
Results
Forty-four studies addressed eight different chronic disease populations. The most common program delivery format was face-to-face in a group setting (42%), 39% of programs were informed by a learning theory, and their median cumulative length was 8 hours. Positive outcomes were associated with a specific, group-based energy management program in people with multiple sclerosis. The evidence on other energy management programs and in other chronic disease populations was more limited and inconclusive.
Conclusions
Further research is needed to understand the impact of energy management education in chronic disease populations beyond multiple sclerosis, and its impact on occupational performance.
AcciarresiMBogousslavskyJPaciaroniM (2014)
Post-stroke fatigue: Epidemiology, clinical characteristics and treatment. European Neurology72(5–6): 255–261.
2.
AkbarNTurpinKPetrinJ, et al. (2018)
A pilot mixed-methods evaluation of MS INFoRm: A self-directed fatigue management resource for individuals with multiple sclerosis. International Journal of Rehabilitation Research41(2): 114–121.
3.
ArkseyHO’MalleyL (2005)
Scoping studies: Towards a methodological framework. International Journal of Social Research Methodology8(1): 19–32.
4.
AsanoMPreissnerKDuffyR, et al. (2015)
Goals set after completing a teleconference-delivered program for managing multiple sclerosis fatigue. American Journal of Occupational Therapy69(3): 6903290010p1.
5.
BaltzanMAScottASWolkoveN, et al. (2011)
Fatigue in COPD: Prevalence and effect on outcomes in pulmonary rehabilitation. Chronic Respiratory Disease8(2): 119–128.
6.
BarsevickAMDudleyWBeckS, et al. (2004)
A randomized clinical trial of energy conservation for patients with cancer-related fatigue. Cancer100(6): 1302–1310.
7.
BarsevickAMWhitmerKSweeneyC, et al. (2002)
A pilot study examining energy conservation for cancer treatment–related fatigue.Cancer Nursing25(5): 333–341.
8.
BlikmanLJHuisstedeBMKooijmansH, et al. (2013)
Effectiveness of energy conservation treatment in reducing fatigue in multiple sclerosis: A systematic review and meta-analysis. Archives of Physical Medicine and Rehabilitation94(7): 1360–1376.
9.
BlikmanLJvan MeeterenJTwiskJW, et al. (2017)
Effectiveness of energy conservation management on fatigue and participation in multiple sclerosis: A randomized controlled trial. Multiple Sclerosis Journal23(11): 1527–1541.
10.
BlikmanLJMvan MeeterenJTwiskJWR, et al. (2019)
Energy conservation management for people with multiple sclerosis-related fatigue: Who benefits?American Journal of Occupational Therapy73(4): 7304205040p1–7304205040p9.
11.
BoehmNMuehlbergHStubeJE (2015)
Managing poststroke fatigue using telehealth: A case report. American Journal of Occupational Therapy69(6): 6906350020p1.
12.
BraleyTJChervinRD (2010)
Fatigue in multiple sclerosis: Mechanisms, evaluation, and treatment. Sleep33(8): 1061–1067.
13.
Bruggeman-EvertsFZWolversMDJvan de SchootR, et al. (2017)
Effectiveness of two web-based interventions for chronic cancer-related fatigue compared to an active control condition: Results of the “Fitter na kanker” randomized controlled trial. Journal of Medical Internet Research19(1): e336.
14.
ChaudhuriABehanPO (2004)
Fatigue in neurological disorders. The Lancet363(9413): 978–988.
15.
DawsonDMcEwenSPolatajkoH (eds) (2017) Cognitive Orientation to Daily Occupational Performance in Occupational Therapy: Using the CO-OP Approach (TM) to Enable Participation Across the Lifespan.
Bethesda:
American Occupational Therapy.
16.
DawsonDRGayaAHuntA, et al. (2009)
Using the Cognitive Orientation to Occupational Performance (CO-OP) with adults with executive dysfunction following traumatic brain injury. Canadian Journal of Occupational Therapy76(2): 115–127.
17.
DougallDJohnsonAGoldsmithK, et al. (2014)
Adverse events and deterioration reported by participants in the PACE trial of therapies for chronic fatigue syndrome. Journal of Psychosomatic Research77(1): 20–26.
18.
FiniAde Almeida Lopes Monteiro da CruzD (2009)
Characteristics of fatigue in heart failure patients: A literature review. Revista Latino-Americana de Enfermagem17(4): 557–565.
19.
FinlaysonML (2005)
Pilot study of an energy conservation education program delivered by telephone conference call to people with multiple sclerosis. NeuroRehabilitation20(4): 267–277.
20.
FinlaysonMLPreissnerKChoC, et al. (2011)
Randomized trial of a teleconference-delivered fatigue management program for people with multiple sclerosis. Multiple Sclerosis Journal17(9): 1130–1140.
21.
FinlaysonMLPreissnerKChoC (2012)
Outcome moderators of a fatigue management program for people with multiple sclerosis. American Journal of Occupational Therapy66(2): 187–197.
22.
FinlaysonMLPreissnerKChoC (2013)
Impact of comorbidity on fatigue management intervention outcomes among people with multiple sclerosis: An exploratory investigation. International Journal of MS Care15(1): 21–26.
23.
FinlaysonMLShevilELuoP, et al. (2007)
Effects of cognition on quiz performance, behavior change, and vitality after energy conservation course among people with multiple sclerosis. International Journal of MS Care9(1): 13–21.
24.
FriedbergFAdamowiczJCaikauskaiteI, et al. (2016)
Efficacy of two delivery modes of behavioral self-management in severe chronic fatigue syndrome. Fatigue: Biomedicine, Health & Behavior4(3): 158–174.
25.
FurstGPGerberLHSmithCC, et al. (1987)
A program for improving energy conservation behaviors in adults with rheumatoid arthritis.American Journal of Occupational Therapy41(2): 102–111.
26.
García JalónEGLennonSPeoplesL, et al. (2013)
Energy conservation for fatigue management in multiple sclerosis: A pilot randomized controlled trial. Clinical Rehabilitation27(1): 63–74.
27.
GhahariSPackerT (2012)
Effectiveness of online and face-to-face fatigue self-management programmes for adults with neurological conditions. Disability and Rehabilitation34(7): 564–573.
28.
GhahariSLeigh PackerTPassmoreAE (2010)
Effectiveness of an online fatigue self-management programme for people with chronic neurological conditions: A randomized controlled trial. Clinical Rehabilitation24(8): 727–744.
29.
GhahariSPackerTLPassmoreAE (2009)
Development, standardisation and pilot testing of an online fatigue self-management program. Disability and Rehabilitation31(21): 1762–1772.
30.
HamiltonWWatsonJRoundA (2010)
Investigating fatigue in primary care. BMJ341: c4259.
31.
HoddinottPAllanKAvenellA, et al. (2010)
Group interventions to improve health outcomes: A framework for their design and delivery. BMC Public Health10(1): 800.
32.
HolbergCFinlaysonML (2007)
Factors influencing the use of energy conservation strategies by persons with multiple sclerosis. American Journal of Occupational Therapy61(1): 96–107.
33.
JasonLA (2017)
The PACE trial missteps on pacing and patient selection. Journal of Health Psychology22(9): 1141–1145.
34.
JonesJMOlsonKCattonP, et al. (2016)
Cancer-related fatigue and associated disability in post-treatment cancer survivors. Journal of Cancer Survivorship: Research and Practice10(1): 51–61.
35.
KimYJRogersJCRainaKD, et al. (2016)
An intervention for cardiac arrest survivors with chronic fatigue: A feasibility study with preliminary outcomes. Resuscitation105: 109–115.
36.
KimYJRogersJCRainaKD, et al. (2017)
Solving fatigue-related problems with cardiac arrest survivors living in the community. Resuscitation118: 70–74.
37.
LambALFinlaysonMLMathiowetzVG, et al. (2005)
The outcomes of using self-study modules in energy conservation education for people with multiple sclerosis. Clinical Rehabilitation19(5): 475–481.
38.
McCormackRCO’SheaFDoranM, et al. (2018)
Impact of a fatigue management in work programme on meeting work demands of individuals with rheumatic diseases: A pilot study. Musculoskeletal Care16(3): 398–404.
39.
McDermottCRichardsSCMAnkersS, et al. (2004)
An evaluation of a chronic fatigue lifestyle management programme focusing on the outcome of return to work or training. British Journal of Occupational Therapy67(6): 269–273.
40.
MandliyaADasAUnnikrishnanJP, et al. (2016)
Post-stroke fatigue is an independent predictor of post-stroke disability and burden of care: A path analysis study. Topics in Stroke Rehabilitation23(1): 1–7.
41.
MathiowetzVGBuschML (2006)
Participant evaluation of energy conservation course for people with multiple sclerosis. International Journal of MS Care8(3): 98–106.
42.
MathiowetzVGFinlaysonMLMatuskaKM, et al. (2005)
Randomized controlled trial of an energy conservation course for persons with multiple sclerosis. Multiple Sclerosis Journal11(5): 592–601.
43.
MathiowetzVGMatuskaKMFinlaysonML, et al. (2007)
One-year follow-up to a randomized controlled trial of an energy conservation course for persons with multiple sclerosis. International Journal of Rehabilitation Research30(4): 305–313.
44.
MathiowetzVGMatuskaKMMurphyME (2001)
Efficacy of an energy conservation course for persons with multiple sclerosis. Archives of Physical Medicine and Rehabilitation82(4): 449–456.
45.
MatuskaKMathiowetzVGFinlaysonML (2007)
Use and perceived effectiveness of energy conservation strategies for managing multiple sclerosis fatigue. American Journal of Occupational Therapy61(1): 62–69.
46.
MurphySLLydenAKSmithDM, et al. (2010)
Effects of a tailored activity pacing intervention on pain and fatigue for adults with osteoarthritis. American Journal of Occupational Therapy64(6): 869–876.
47.
MurtaghFEMAddington-HallJHigginsonIJ (2007)
The prevalence of symptoms in end-stage renal disease: A systematic review. Advances in Chronic Kidney Disease14(1): 82–99.
48.
Norberg E-B, Löfgre B, Boma K, et al (2017). A client centred programme focusing energy conservation for people with heart failure. Scandinavian Journal of Occupational Therapy 24(6): 455--467.
49.
NoarSMBenacCNHarrisMS (2007)
Does tailoring matter? Meta-analytic review of tailored print health behavior change interventions. Psychological Bulletin133(4): 673–693.
50.
PackerTLBrinkNBSauriolA (1995) Managing Fatigue: A Six-Week Course for Energy Conservation.
Tucson:
Therapy Skill Builders.
51.
PétrinJAkbarNTurpinK, et al. (2018)
The experience of persons with multiple sclerosis using MS INFoRm: An interactive fatigue management resource. Qualitative Health Research28(5): 778–788.
52.
PiperBF (1993)
Fatigue and cancer: Inevitable companions?Supportive Care in Cancer1(6): 285–286.
53.
PolatajkoHJMcEwenSERyanJD, et al. (2012)
Pilot randomized controlled trial investigating cognitive strategy use to improve goal performance after stroke. American Journal of Occupational Therapy66(1): 104–109.
54.
PolinskiJMBarkerTGaglianoN, et al. (2016)
Patients’ satisfaction with and preference for telehealth visits. Journal of General Internal Medicine31(3): 269–275.
55.
PopayJRobertsHSowdenA, et al. (2006) Guidance on the Conduct of Narrative Synthesis in Systematic Reviews: A Product from the ESRC Methods Programme 1.
56.
RainaKDMorseJQChisholmD, et al. (2016)
Feasibility of a cognitive behavioral intervention to manage fatigue in individuals with traumatic brain injury: A pilot study. Journal of Head Trauma Rehabilitation31(5): E41–E49.
57.
Ranka J and Chapparo C (1997) Definition of terms. In: Chapparo C and J. Ranka J (eds) Occupational Performance Model (Australia): Monograph 1. Sydney: Occupational Performance Network, pp. 58--60.
58.
Racine M, Jensen MP, Harth M, et al (2019) Operant learning versus energy conservation activity pacing treatments in a sample of patients with fibromyalgia syndrome: A pilot randomized controlled trial. The Journal of Pain 20(4): 420--439.
59.
SadeghiEGozaliNTabriziFM (2016)
Effects of energy conservation strategies on cancer related fatigue and health promotion lifestyle in breast cancer survivors: A randomized control trial. Asian Pacific Journal of Cancer Prevention17(10): 4783–4790.
60.
SauterCZebenholzerKHisakawaJ, et al. (2008)
A longitudinal study on effects of a six-week course for energy conservation for multiple sclerosis patients. Multiple Sclerosis Journal14(4): 500–505.
61.
Sharpe M, Goldsmith KA, Johnson AL, et al. (2015) Rehabilitative treatments for chronic fatigue syndrome: long-term follow-up from the PACE trial. The Lancet Psychiatry 2(12): 1067--1074.
62.
Smits-EngelsmanBCMBlankRVan Der KaayAC, et al. (2013)
Efficacy of interventions to improve motor performance in children with developmental coordination disorder: A combined systematic review and meta-analysis: Review. Developmental Medicine & Child Neurology55(3): 229–237.
63.
TriccoACLillieEZarinW, et al. (2018)
PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation. Annals of Internal Medicine169(7): 467–473.
64.
Van HeestKNLMogushARMathiowetzVG (2017)
Effects of a one-to-one fatigue management course for people with chronic conditions and fatigue. American Journal of Occupational Therapy71(4): 7104100020p1.
65.
VanageSMGilbertsonKKMathiowetzVG (2003)
Effects of an energy conservation course on fatigue impact for persons with progressive multiple sclerosis. American Journal of Occupational Therapy57(3): 315–323.
66.
WeisJ (2011)
Cancer-related fatigue: Prevalence, assessment and treatment strategies. Expert Review of Pharmacoeconomics & Outcomes Research11(4): 441–446.
67.
WhitePGoldsmithKJohnsonA, et al. (2011)
Comparison of adaptive pacing therapy, cognitive behaviour therapy, graded exercise therapy, and specialist medical care for chronic fatigue syndrome (PACE): A randomised trial. The Lancet377(9768): 823–836.
WilshireCKindlonTMattheesA, et al. (2017)
Can patients with chronic fatigue syndrome really recover after graded exercise or cognitive behavioural therapy? A critical commentary and preliminary re-analysis of the PACE trial. Fatigue: Biomedicine, Health & Behavior5(1): 43–56.
70.
WilsonSR (1997)
Individual versus group education: Is one better?Patient Education and Counseling32(1 Suppl): S67–S75.
YoungGR (1991)
Energy conservation, occupational therapy, and the treatment of post-polio sequelae. Orthopedics14(11): 1233–1239.
73.
YuenHKMitchamMDMorganLI (2006)
Managing post-therapy fatigue for cancer survivors using energy conservation training. Journal of Allied Health35(2): 121–139.
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
