Occupational Therapy treatment for the management of fatigue in individuals with Multiple Sclerosis: Outcome Research

Abstract

Abstract Background. 80% of people with Multiple Sclerosis (MS) describe fatigue as the most disabling symptom. Several studies have demonstrated the effectiveness of fatigue management programs in reducing the impact of fatigue and improving the Quality of Life (QoL). None of these were based on the benefit that this intervention has on social participation and environment management. This study aims to evaluate the management of environment and social participation following an Occupational Therapy (OT) intervention based on the teaching of energy conservation strategies in people with MS; the secondary endpoint is to evaluate the impact of fatigue, QoL and sleep quality. Methods. The intervention was administered as an outpatient program to adults with a confirmed diagnosis of MS, Expanded Disability Status Scale < 5,5, Fatigue Severity Scale ≥ 4. The intervention was based on a five-week program, and follow-up was performed 3 months after the end of the administration. The environmental impact was measured using the Craig Hospital Inventory of Environmental Factors scale, the level of social integration was assessed through the Community Integration Questionnaire and the Impact on Participation and Autonomy. Results. 19 people were recruited, pre- and post-treatment, and after 3 months evaluations showed statistically significant data for all outcomes with a p < 0.05. Conclusion. Intervention based on fatigue management in people with MS improves the management of environment and social integration; it shows an improvement of the perception of fatigue, QoL and sleep quality. It confirms the importance of implementing groups for the management of fatigue also in Italy.