title: Depression, fatigue, and health-related quality of life among people with advanced multiple sclerosis: results from an exploratory telerehabilitation study.
abstract: This study reports on secondary data, depression, fatigue and health-related quality of life (HRQOL), collected on people with advanced multiple sclerosis (MS) as part of a larger study of the impact of a telerehabilitation intervention on people with severe mobility impairment. People with spinal cord injuries (SCIs) (n=111) and the prevention of pressure sores were the primary group of interest of the project. The focus here is on data collected from people with advanced MS (n=27), who were included as an exploratory cohort, as they experience increased risk of pressure ulcer development as their level of mobility declines. The study consisted of a nine-week intervention with three randomized groups: video, telephone, and standard care. Aside from information on pressure sores, data were also collected on fatigue, depression, and HRQOL for a two-year follow-up period. For the video group HRQOL scores trended higher and fatigue and depression scores lower for 24 months. Fatigue scores were significantly lower for the video group at month six, 12, and 18. In the sample overall, fatigue symptoms were far more prominent than depressive symptoms and affected 100% higher rates of depression than women. At baseline, controlling for Extended Disability Status Score (EDSS), depression and fatigue were correlated. However, contrary to indications from previous cross-sectional studies, no consistent relationship was observed over time between the two. Telerehabilitation interventions for people with advanced MS warrant further investigation. Findings here suggest that such interventions may be beneficial, although the results need affirmation through larger samples. In addition, the higher prevalence of male depression merits serious attention.
authors.affiliation: Department of Health Policy and Management, Rollins School of Public Health of Emory University, 1518 Clifton Road, NE, Atlanta, GA 30322, USA.
authors.forename: Amanda
authors.initials: A
authors.lastname: Egner
authors.forename: V L
authors.initials: VL
authors.lastname: Phillips
authors.forename: Rakhee
authors.initials: R
authors.lastname: Vora
authors.forename: Edith
authors.initials: E
authors.lastname: Wiggers
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003866:Depressive Disorder / Q000209:etiology* / Q000534:rehabilitation*; D005221:Fatigue / Q000209:etiology* / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications* / Q000534:rehabilitation*; D010342:Patient Acceptance of Health Care; D017060:Patient Satisfaction; D003668:Pressure Ulcer / Q000209:etiology* / Q000517:prevention & control*; D011788:Quality of Life; D012720:Severity of Illness Index; D017216:Telemedicine; D013997:Time Factors; D016896:Treatment Outcome