OBJECTIVES: To systematically review the effects of energy conservation management (ECM) treatment for fatigue in MS. We also studied the effect of ECM-treatment on restrictions in participation and quality of life (QoL). DATA SOURCES: PubMed, CINAHL, Embase and Web of Knowledge were searched to identify relevant RCTs and CCTs. STUDY SELECTION: To select potential studies, two reviewers independently applied the inclusion criteria. DATA EXTRACTION: Two reviewers independently extracted data and assessed the methodological quality of the studies included. If meta-analysis was not possible, qualitative best-evidence synthesis was used to summarize the results. DATA SYNTHESIS: The searches identified 532 studies, 6 of which were included. The studies compared the short-term effects of ECM-treatment and control treatment on fatigue and QoL; one study reported short- and mid-term effects on participation, but found no evidence for effectiveness. Meta-analyses (2 RCTs, n = 350) showed that ECM-treatment was more effective than no treatment in improving subscale scores of the (I) FIS (Fatigue Impact Scale): cognitive (pooled MD -2.91; 95% CI -4.32 to -1.50), physical (-2.99; -4.47 to -1.52) and psychosocial (-6.05; -8.72 to -3.37); and (II) QoL: role physical (17.26; 9.69 to 24.84), social function (6.91; 1.32 to 12.49) and mental health (5.55; 2.27 to 8.83). Limited or no evidence was found for the effectiveness of ECM-treatment on the other outcomes in the short- or mid-term. None of the studies reported long-term results. CONCLUSIONS: The systematic review results provide evidence that, in the short-term, ECM-treatment can be more effective than no treatment (waiting controls) in reducing the impact of fatigue and in improving three QoL scales: role physical, social function and mental health in fatigued MS patients. More RCTs that also study long-term results are needed.

Full text (sometimes free) may be available at these link(s):      help

• DOI
• PubMed
• PDF locator
• publisher