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

Lyan J.M. Blikman; Jetty van Meeteren; Jos W.R. Twisk; Fred A.J. de Laat; Vincent de Groot; Heleen Beckerman; Henk J. Stam; Johannes B.J. Bussmann; A. Malekzadeh; L. E. Van Den Akker; M. Looijmans; S. A. Sanches; J. Dekker; E. H. Collette; B. W. Van Oosten; C. E. Teunissen; M. A. Blankenstein; I. C.J.M. Eijssen; M. Rietberg; M. Heine; O. Verschuren; G. Kwakkel; J. M.A. Visser-Meily; I. G.L. Van De Port; E. Lindeman; R. Q. Hintzen; H. G.A. Hacking; E. L. Hoogervorst; S. T.F.M. Frequin; H. Knoop; B. A. De Jong; G. Bleijenberg; M. C. Verhulsdonck; E. Th L. van Munster; C. J. Oosterwijk; G. J. Aarts

doi:10.1177/1352458517702751

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

Lyan J.M. Blikman, Jetty van Meeteren^*, Jos W.R. Twisk, Fred A.J. de Laat, Vincent de Groot, Heleen Beckerman, Henk J. Stam, Johannes B.J. Bussmann, A. Malekzadeh, L. E. Van Den Akker, M. Looijmans, S. A. Sanches, J. Dekker, E. H. Collette, B. W. Van Oosten, C. E. Teunissen, M. A. Blankenstein, I. C.J.M. Eijssen, M. Rietberg, M. HeineO. Verschuren, G. Kwakkel, J. M.A. Visser-Meily, I. G.L. Van De Port, E. Lindeman, R. Q. Hintzen, H. G.A. Hacking, E. L. Hoogervorst, S. T.F.M. Frequin, H. Knoop, B. A. De Jong, G. Bleijenberg, M. C. Verhulsdonck, E. Th L. van Munster, C. J. Oosterwijk, G. J. Aarts,

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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.

Original language	English
Pages (from-to)	1527-1541
Number of pages	15
Journal	Multiple Sclerosis Journal
Volume	23
Issue number	11
DOIs	https://doi.org/10.1177/1352458517702751
Publication status	Published - 1 Oct 2017

Keywords

Energy conservation
Fatigue
Fatigue management
Multiple sclerosis
Participation
Randomized controlled trial
Rehabilitation medicine

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10.1177/1352458517702751

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Blikman, L. J. M., van Meeteren, J., Twisk, J. W. R., de Laat, F. A. J., de Groot, V., Beckerman, H., Stam, H. J., Bussmann, J. B. J., Malekzadeh, A., Van Den Akker, L. E., Looijmans, M., Sanches, S. A., Dekker, J., Collette, E. H., Van Oosten, B. W., Teunissen, C. E., Blankenstein, M. A., Eijssen, I. C. J. M., Rietberg, M. (2017). Effectiveness of energy conservation management on fatigue and participation in multiple sclerosis: A randomized controlled trial. Multiple Sclerosis Journal, 23(11), 1527-1541. https://doi.org/10.1177/1352458517702751

@article{6f8220018074402f86d36ee1df362cb2,

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

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.",

keywords = "Energy conservation, Fatigue, Fatigue management, Multiple sclerosis, Participation, Randomized controlled trial, Rehabilitation medicine",

author = "Blikman, {Lyan J.M.} and {van Meeteren}, Jetty and Twisk, {Jos W.R.} and {de Laat}, {Fred A.J.} and {de Groot}, Vincent and Heleen Beckerman and Stam, {Henk J.} and Bussmann, {Johannes B.J.} and A. Malekzadeh and {Van Den Akker}, {L. E.} and M. Looijmans and Sanches, {S. A.} and J. Dekker and Collette, {E. H.} and {Van Oosten}, {B. W.} and Teunissen, {C. E.} and Blankenstein, {M. A.} and Eijssen, {I. C.J.M.} and M. Rietberg and M. Heine and O. Verschuren and G. Kwakkel and Visser-Meily, {J. M.A.} and {Van De Port}, {I. G.L.} and E. Lindeman and Hintzen, {R. Q.} and Hacking, {H. G.A.} and Hoogervorst, {E. L.} and Frequin, {S. T.F.M.} and H. Knoop and {De Jong}, {B. A.} and G. Bleijenberg and Verhulsdonck, {M. C.} and {van Munster}, {E. Th L.} and Oosterwijk, {C. J.} and Aarts, {G. J.}",

note = "Publisher Copyright: {\textcopyright} 2017, {\textcopyright} The Author(s), 2017.",

year = "2017",

month = oct,

day = "1",

doi = "10.1177/1352458517702751",

language = "English",

volume = "23",

pages = "1527--1541",

number = "11",

}

Blikman, LJM, van Meeteren, J, Twisk, JWR, de Laat, FAJ, de Groot, V, Beckerman, H, Stam, HJ, Bussmann, JBJ, Malekzadeh, A, Van Den Akker, LE, Looijmans, M, Sanches, SA, Dekker, J, Collette, EH, Van Oosten, BW, Teunissen, CE, Blankenstein, MA, Eijssen, ICJM, Rietberg, M, Heine, M , Verschuren, O, Kwakkel, G, Visser-Meily, JMA, Van De Port, IGL, Lindeman, E, Hintzen, RQ, Hacking, HGA, Hoogervorst, EL, Frequin, STFM, Knoop, H, De Jong, BA, Bleijenberg, G, Verhulsdonck, MC, van Munster, ETL, Oosterwijk, CJ, Aarts, GJ 2017, 'Effectiveness of energy conservation management on fatigue and participation in multiple sclerosis: A randomized controlled trial', Multiple Sclerosis Journal, vol. 23, no. 11, pp. 1527-1541. https://doi.org/10.1177/1352458517702751

TY - JOUR

T1 - Effectiveness of energy conservation management on fatigue and participation in multiple sclerosis

T2 - A randomized controlled trial

AU - Blikman, Lyan J.M.

AU - van Meeteren, Jetty

AU - Twisk, Jos W.R.

AU - de Laat, Fred A.J.

AU - de Groot, Vincent

AU - Beckerman, Heleen

AU - Stam, Henk J.

AU - Bussmann, Johannes B.J.

AU - Malekzadeh, A.

AU - Van Den Akker, L. E.

AU - Looijmans, M.

AU - Sanches, S. A.

AU - Dekker, J.

AU - Collette, E. H.

AU - Van Oosten, B. W.

AU - Teunissen, C. E.

AU - Blankenstein, M. A.

AU - Eijssen, I. C.J.M.

AU - Rietberg, M.

AU - Heine, M.

AU - Verschuren, O.

AU - Kwakkel, G.

AU - Visser-Meily, J. M.A.

AU - Van De Port, I. G.L.

AU - Lindeman, E.

AU - Hintzen, R. Q.

AU - Hacking, H. G.A.

AU - Hoogervorst, E. L.

AU - Frequin, S. T.F.M.

AU - Knoop, H.

AU - De Jong, B. A.

AU - Bleijenberg, G.

AU - Verhulsdonck, M. C.

AU - van Munster, E. Th L.

AU - Oosterwijk, C. J.

AU - Aarts, G. J.

PY - 2017/10/1

Y1 - 2017/10/1

N2 - 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.

AB - 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.

KW - Energy conservation

KW - Fatigue

KW - Fatigue management

KW - Multiple sclerosis

KW - Participation

KW - Randomized controlled trial

KW - Rehabilitation medicine

UR - http://www.scopus.com/inward/record.url?scp=85043394080&partnerID=8YFLogxK

U2 - 10.1177/1352458517702751

DO - 10.1177/1352458517702751

M3 - Article

AN - SCOPUS:85043394080

SN - 1352-4585

VL - 23

SP - 1527

EP - 1541

JO - Multiple Sclerosis Journal

JF - Multiple Sclerosis Journal

IS - 11

ER -

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

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