Article

OBJECTIVES: To systematically review the effects of energy conservation
management (ECM) treatment for fatigue in multiple sclerosis (MS), and to study
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 randomized controlled trials (RCTs) and controlled clinical
trials. STUDY SELECTION: To select potential studies, 2 reviewers independently
applied the inclusion criteria. DATA EXTRACTION: Two reviewers independently
extracted data and assessed the methodologic 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; 1 study reported short-term and midterm
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 (1) Fatigue Impact Scale: cognitive (mean
difference [MD]=-2.91; 95% confidence interval [CI], -4.32 to -1.50), physical
(MD=-2.99; 95% CI, -4.47 to -1.52), and psychosocial (MD=-6.05; 95% CI, -8.72 to
-3.37); and (2) QoL: role physical (MD=17.26; 95% CI, 9.69-24.84), social
function (MD=6.91; 95% CI, 1.32-12.49), and mental health (MD=5.55; 95% CI,
2.27-8.83). Limited or no evidence was found for the effectiveness of ECM
treatment on the other outcomes in the short-term or midterm. 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 3
QoL scales-role physical, social function, and mental health-in fatigued patients
with MS. More RCTs that also study long-term results are needed.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS