title: The cooling-suit: case studies of its influence on fatigue among eight individuals with multiple sclerosis.
abstract: OBJECTIVE
  To study if the use of a cooling-suit by individuals with multiple sclerosis (MS) influenced their experience of fatigue and consequent restrictions in daily life.
  
  
  BACKGROUND
  The majority of MS patients consider fatigue as one of their most disabling symptoms and as having a significant impact on their daily lives. Fatigue often increases in a warm environment. A cooling-suit has been reported as a practical method of cooling, but the effect on fatigue has not yet been studied.
  
  
  METHODS
  Eight individuals used a cooling-suit in their own homes during a test-period. In a single case-control design, their experience of fatigue was studied before and after. Quantitative and qualitative methods were used: self-assessments using the Fatigue Impact Scale (FIS), open-ended interviews and semi-structured diaries.
  
  
  RESULTS
  All study participants reported a reduction in fatigue during the test period. On the FIS, they scored reductions in the physical, cognitive and psycho-social dimensions of daily life. They experienced fatigue less often and for shorter periods. In their diaries and interviews they described decreased muscular strain, less sense of fatigue in relation to intake of food and positive effects on cognitive, social or affective problems related to fatigue.
  
  
  CONCLUSIONS
  The cooling-suit is a practical method for cooling. It gives freedom and flexibility and can be used regardless of setting. Nurses who meet heat-sensitive individuals with MS have the opportunity to give information on cooling methods, including how to use a cooling-suit. In this pilot study we found that individuals with MS who suffered from fatigue reported a number of improvements in quality of daily life.
  
  
  CONCLUSIONS
  The result indicates that use of a cooling-suit by individuals with MS may decrease their sense of fatigue. In this sample positive outcomes on daily life situations were reported. Further studies are needed to support these results.
authors.affiliation: Department of Nursing, University of Trollhättan/Uddevalla, Vänersborg, Sweden. gullvi.flensner@htu.se
authors.forename: Gullvi
authors.initials: G
authors.lastname: Flensner
authors.forename: Catharina
authors.initials: C
authors.lastname: Lindencrona
mesh_terms: D016022:Case-Control Studies; D017679:Cryotherapy / Q000295:instrumentation*; D005221:Fatigue / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications*; D010865:Pilot Projects; D011788:Quality of Life; D012656:Self-Help Devices; D012720:Severity of Illness Index; D016896:Treatment Outcome