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STUDY—Effectiveness of energy conservation management on fatigue, participation in MS

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  • STUDY—Effectiveness of energy conservation management on fatigue, participation in MS

    Does this study refute the popular "Spoon Theory"? Without reading the entire study, I can't say for sure, but it suggests that it makes little difference long term whether people with multiple sclerosis horde spoons or pass them out willy-nilly. Fatigue is fatigue, and while we may have some day-to-day control over this debilitating symptom, these results show that energy conservation techniques are no better than a placebo. - D

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


    Lyan JM Blikman, Jetty van Meeteren, Jos WR Twisk, ...
    First Published May 22, 2017 Research Article

    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.

    Dave Bexfield
    ActiveMSers
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