This study aims to evaluate the effect of an occupation-focused and occupation-based group intervention for fatigue management on the perception of environment barriers and social participation, and secondarily the impact on quality of life and sleep quality.
Material and Methods:
For this quasi-experimental study, 19 participants with a mean age of 45 (13.7), with 84.2% having Relapsing-Remitting Multiple Sclerosis with Expanded Disability Status Scale mean 2.6, were recruited. The outcome measures were administering pre-post test, and the follow-up was at 3 months using T-test for inferential analysis. The outcome measures used for the primary outcomes were the Craig Hospital Inventory of Environmental Factors scale, the Community Integration Questionnaire, and the Impact on Participation and Autonomy.
Results:
All outcomes showed statistically significant improvement after treatment. At 3-month follow-up, the results maintained positive results except for the General Sleep Disturbance Scale and the MSQoL-54, which showed a slight worsening in total scores with respect to post-treatment.
Conclusion:
This study fits into a widely studied context, emphasizing the importance of implementing occupation-focused group interventions for fatigue management. Furthermore, this study showed that this type of intervention leads to an improvement on the perception of environmental barriers and social participation.
AkbarfahimiMNabaviSMKorB, et al. (2020) The effectiveness of occupational therapy-based sleep interventions on quality of life and fatigue in patients with multiple sclerosis: A pilot randomized clinical trial Study. Neuropsychiatric Disease and Treatment16: 1369–1379.
2.
AmatyaBKhanFGaleaM (2019) Rehabilitation for people with multiple sclerosis: An overview of Cochrane Reviews. Cochrane Database of Systematic Reviews2019: CD012732.
3.
The American Journal of Occupational Therapy (2020) Occupational Therapy Practice Framework: Domain and Process—Fourth Edition. American Journal of Occupational Therapy74(Suppl. 2): 7412410010p1–7412410010p87.
4.
FauciAS (2021) DLKSLHDL. Principi Di Medicina Interna.
5.
AsanoMBergEJohnsonK, et al. (2015) A scoping review of rehabilitation interventions that reduce fatigue among adults with multiple sclerosis. Disability and Rehabilitation37: 729–738.
6.
AskariSFanelliDHarveyK (2021) Cognitive fatigue interventions for people with multiple sclerosis: A scoping review. Multiple Sclerosis and Related Disorders55: 103213.
7.
BaileyAChannonSBeaumontJG (2007) The relationship between subjective fatigue and cognitive fatigue in advanced multiple sclerosis. Multiple Sclerosis Journal13: 73–80.
8.
BarinLSalmenADisantoG, et al. (2018) The disease burden of Multiple Sclerosis from the individual and population perspective: Which symptoms matter most?Multiple Sclerosis and Related Disorders25: 112–121.
9.
BerardiAGaleotoGGuarinoD, et al. (2019) Construct validity, test-retest reliability, and the ability to detect change of the Canadian Occupational Performance Measure in a spinal cord injury population. Spinal Cord Series and Cases5: 52.
10.
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: 1360–1376.
11.
BorragánGSlamaHBartolomeiM, et al. (2017) Cognitive fatigue: A time-based resource-sharing account. Cortex89: 71–84.
12.
BrañasPJordanRFry-SmithA, et al. (2000) Treatments for fatigue in multiple sclerosis: a rapid and systematic review. Health Technology Assessment4(27): 1–61.
13.
CattaneoDLamersIBertoniR, et al. (2017) Participation restriction in people with multiple sclerosis: prevalence and correlations with cognitive, walking, balance, and upper limb impairments. Archives of Physical Medicine and Rehabilitation98: 1308–1315.
14.
ChaudhuriABehanPO (2004) Fatigue in neurological disorders. Lancet (London, England)363: 978–88.
15.
CurcioGTempestaDScarlataS, et al. (2013) Validity of the Italian Version of the Pittsburgh Sleep Quality Index (PSQI). Neurological Sciences34: 511–519.
16.
EnokaRMAlmuklassAMAlenazyM, et al. (2021) Distinguishing between fatigue and fatigability in multiple sclerosis. Neurorehabilitation and Neural Repair35: 960–973.
17.
FeenaughtyL (2023) Social network characteristics and correlations with cognitive, psychosocial, and speech function and communication participation for adults with multiple sclerosis: A pilot study. Journal of Speech, Language, and Hearing Research66: 163–177.
18.
FinlaysonMPreissnerKChoC, et al. (2011) Randomized trial of a teleconference-delivered fatigue management program for people with multiple sclerosis. Multiple Sclerosis Journal17: 1130–1140.
19.
FisherAG (2013) Occupation-centred, occupation-based, occupation-focused: Same, same or different?Scandinavian Journal of Occupational Therapy20: 162–173.
20.
FiskJDRitvoPGRossL, et al. (1994) Measuring the functional impact of fatigue: Initial validation of the fatigue impact scale. Clinical Infectious Diseases18(Suppl. 1): S79-83.
21.
FlemingJNalderEAlves-SteinS, et al. (2014) The effect of environmental barriers on community integration for individuals with moderate to severe traumatic brain injury. Journal of Head Trauma Rehabilitation29: 125–135.
22.
FlensnerGEkA-CLandtblomA-M, et al. (2008) Fatigue in relation to perceived health: people with multiple sclerosis compared with people in the general population. Scandinavian Journal of Caring Sciences22: 391–400.
23.
FranchignoniFFerrieroGGiordanoA, et al. (2007) Rasch psychometric validation of the impact on participation and autonomy questionnaire in people with Parkinson’s disease. Europa medicophysica43: 451–61.
24.
GaleotoGScialpiAGrassiML, et al. (2021) General Sleep Disturbance Scale: Translation, cultural adaptation, and psychometric properties of the Italian version. CRANIO39: 326–334.
25.
García JalónEGLennonSPeoplesL, et al. (2013) Energy conservation for fatigue management in multiple sclerosis: A pilot randomized controlled trial. Clinical Rehabilitation27: 63–74.
26.
GiordanoATestaSBassiM, et al. (2020) Assessing measurement invariance of MSQOL-54 across Italian and English versions. Quality of Life Research29: 783–791.
27.
GoliroshanSBabamohamadiHMohammadiE, et al. (2023a) Barriers to and facilitators of adjustment among Iranian multiple sclerosis patients: A qualitative study. Qualitative Health Research33: 1068–1079.
28.
GoliroshanSBabamohamadiHMohammadiE, et al. (2023b) Barriers to and facilitators of adjustment among Iranian multiple sclerosis patients: A qualitative study. Qualitative Health Research33(12): 1068–1079.
29.
HammerGPPrelJ-B duBlettnerM (2009) Avoiding bias in observational studies. Deutsches Ärzteblatt international. Epub ahead of print 9 October 2009. DOI: 10.3238/arztebl.2009.0664
30.
HerscheRWeiseAMichelG, et al. (2019) Three-week inpatient energy management education (IEME) for persons with multiple sclerosis-related fatigue: Feasibility of a randomized clinical trial. Multiple Sclerosis and Related Disorders35: 26–33.
31.
HerscheRRoserKWeiseA, et al. (2022) Fatigue self-management education in persons with disease-related fatigue: A comprehensive review of the effectiveness on fatigue and quality of life. Patient Education and Counseling105: 1362–1378.
32.
HosseiniZHomayuniAEtemadifarM (2022) Barriers to quality of life in patients with multiple sclerosis: a qualitative study. BMC Neurology22: 174.
33.
IoncoliMBerardiATofaniM, et al. (2020) Crosscultural Validation of the Community Integration Questionnaire–revised in an Italian population. Occupational Therapy International2020: 1–7.
34.
KhanFPallantJ (2007) Use of international classification of functioning, disability and health (ICF) to describe patient-reported disability in multiple sclerosis and identification of relevant environmental factors. Journal of Rehabilitation Medicine39: 63–70.
35.
KosDDuportailMMeirteJ, et al. (2016) The effectiveness of a self-management occupational therapy intervention on activity performance in individuals with multiple sclerosis-related fatigue: A randomized-controlled trial. International Journal of Rehabilitation Research39: 255–262.
36.
KurtzkeJF (1983) Rating neurologic impairment in multiple sclerosis: An expanded disability status scale (EDSS). Neurology33: 1444–1444.
37.
LiepoldAMathiowetzV (2005) Reliability and validity of the self-efficacy for performing energy conservation strategies assessment for persons with multiple sclerosis. Occupational Therapy International12: 234–249.
38.
MackayLJohnsonAMMoodieST, et al. (2021) Predictors of cognitive fatigue and fatigability in multiple sclerosis. Multiple Sclerosis and Related Disorders56: 103316.
39.
MathiowetzVGFinlaysonMLMatuskaKM, et al. (2005) Randomized controlled trial of an energy conservation course for persons with multiple sclerosis. Multiple Sclerosis Journal11: 592–601.
40.
MillsRGreen LaneS (2012) Measurement of MS fatigue. MS in Focus. Multiple Sclerosis International Federation55: S76–S79.
41.
MindenSLFrankelDHaddenL, et al. (2006) The Sonya Slifka Longitudinal Multiple Sclerosis Study: methods and sample characteristics. Multiple Sclerosis Journal12: 24–38.
42.
MinieraFBerardiAPanuccioF, et al. (2020) Measuring environmental barriers: Validation and cultural adaptation of the Italian version of the Craig hospital inventory of environmental factors (CHIEF) Scale. Occupational Therapy in Health Care34: 373–385.
43.
National Clinical Guideline Centre (UK) (2014) Multiple Sclerosis: Management of Multiple Sclerosis in Primary and Secondary Care. London: National Institute for Health and Care Excellence (UK).
44.
OttJBiller-AndornoNGlässelA (2022) First insights into barriers and facilitators from the perspective of persons with multiple sclerosis: A multiple case study. International Journal of Environmental Research and Public Health19: 10733.
45.
PackerTLBrinkNSauriolA (1995) Managing Fatigue: A Six-week Course for Energy Conservation. Tucson, AZ: Therapy Skill Builders.
46.
PennerI-KPaulF (2017) Fatigue as a symptom or comorbidity of neurological diseases. Nature Reviews Neurology13: 662–675.
47.
Pérez de Heredia-TorresMHuertas-HoyasESánchez-CamareroC, et al. (2020) Occupational performance in multiple sclerosis and its relationship with quality of life and fatigue. European Journal of Physical and Rehabilitation Medicine56: 148–154.
48.
PlowMPackerTMathiowetzVG, et al. (2020) REFRESH protocol: A non-inferiority randomised clinical trial comparing internet and teleconference to in-person ‘Managing Fatigue’ interventions on the impact of fatigue among persons with multiple sclerosis. BMJ Open10: e035470.
49.
Pokryszko-DraganAMarschollekKChojkoA, et al. (2020) Social participation of patients with multiple sclerosis. Advances in Clinical and Experimental Medicine29(4): 469–473.
50.
ReevesBCWellsGAWaddingtonH (2017) Quasi-experimental study designs series—paper 5: A checklist for classifying studies evaluating the effects on health interventions: A taxonomy without labels. Journal of Clinical Epidemiology89: 30–42.
51.
RooneySMoffatFWoodL, et al. (2019) Effectiveness of fatigue management interventions in reducing severity and impact of fatigue in people with progressive multiple sclerosis. International Journal of MS Care21: 35–46.
52.
RuotoloISellittoGIannielloA, et al. (2022) Italian translation and validation of fatigue symptoms and impacts questionnaire in relapsing multiple sclerosis (FSIQ-RMS). Neurological Sciences43: 4925–4932.
53.
SandryJGenovaHMDobryakovaE, et al. (2014) Subjective cognitive fatigue in multiple sclerosis depends on task length. Frontiers in Neurology5: 214.
54.
SchwidSRCovingtonMSegalBM, et al. (2002) Fatigue in multiple sclerosis: current understanding and future directions. Journal of Rehabilitation Research and Development39: 211–224.
55.
SicilianoMChiorriCde MiccoR, et al. (2019) Fatigue in Parkinson’s disease: Italian validation of the Parkinson Fatigue Scale and the Fatigue Severity Scale using a Rasch analysis approach. Parkinsonism & Related Disorders65: 105–110.
56.
SimpsonSFurlongMGiebelC (2021) Exploring the enablers and barriers to social prescribing for people living with long-term neurological conditions: A focus group investigation. BMC Health Services Research21: 1230.
57.
Socialstyrelsen (2016) Nationell riktlinjer for MS och Parkinsons sjukdom. Socialstyrelsen: Swedish National Board of Health and Welfare.
58.
SolariAFilippiniGMendozziL, et al. (1999a) Validation of Italian multiple sclerosis quality of life 54 questionnaire. Journal of Neurology, Neurosurgery & Psychiatry67: 158–162.
59.
SolariAFilippiniGMendozziL, et al. (1999b) Validation of Italian multiple sclerosis quality of life 54 questionnaire. Journal of Neurology, Neurosurgery & Psychiatry67: 158–162.
60.
StroberLB (2018) Quality of life and psychological well-being in the early stages of multiple sclerosis (MS): Importance of adopting a biopsychosocial model. Disability and Health Journal11: 555–561.
61.
ThompsonAJBanwellBLBarkhofF, et al. (2018) Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. The Lancet Neurology17: 162–173.
62.
van GeestQDouwLvan’t KloosterS, et al. (2018) Information processing speed in multiple sclerosis: Relevance of default mode network dynamics. NeuroImage: Clinical19: 507–515.
63.
VitturiBKRahmaniADiniG, et al. (2023) Work barriers and job adjustments of people with multiple sclerosis: A systematic review. Journal of Occupational Rehabilitation33: 450–462.
64.
VucicSBurkeDKiernanMC (2010) Fatigue in multiple sclerosis: Mechanisms and management. Clinical Neurophysiology121: 809–817.
65.
WatsonJ (2021) Research priorities for occupational therapy in the UK. British Journal of Occupational Therapy84: 3–5.
66.
WhiteneckGGHarrison-FelixCLMellickDC, et al. (2004) Quantifying environmental factors: A measure of physical, attitudinal, service, productivity, and policy barriers11No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors(s) or upon any organization with which the author(s) is/are associated. Archives of Physical Medicine and Rehabilitation85: 1324–1335.
67.
WillsOCProbstYC (2022) Understanding lifestyle self-management regimens that improve the life quality of people living with multiple sclerosis: A systematic review and meta-analysis. Health and Quality of Life Outcomes20: 153.
68.
YuC-HMathiowetzV (2014) Systematic review of occupational therapy–related interventions for people with multiple sclerosis: Part 1. Activity and participation. The American Journal of Occupational Therapy68: 27–32.
69.
YuC-HMathiowetzV (n.d.) Systematic review of occupational therapy-related interventions for people with multiple sclerosis: Part 2. Impairment. The American Journal of Occupational Therapy68: 33–38.
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.
