Multidisciplinary fatigue management programme in multiple sclerosis: a randomized clinical trial.
OBJECTIVE
To establish the efficacy of a multidisciplinary fatigue management programme (MFMP) in MS. Method Fifty-one subjects with MS were randomly allocated to group A, who only received the four weeks MFMP, or group B receiving a placebo intervention programme first and the MFMP after 6 months. In both groups, assessment was performed at baseline, 3 weeks and 6 months after the programmes and included Modified Fatigue Impact Scale (MFIS), Fatigue Severity Scale (FSS), MS Self-Efficacy scale (MSSE), Mental Health Inventory (MHI) and Impact on Participation and Autonomy (IPA).


RESULTS
The MFIS showed a significant change over time (F(4,152) = 3.346, P = 0.012), which was similar in both groups (time*group interaction: F(4,152) = 1.094, P = 0.361). A clinically relevant reduction of MFIS score of 10 points or more was found in 17% of individuals following the MFMP, compared to 44% after the placebo intervention programme (P = 0.06). Compared to no intervention, a significant effect of the MFMP after 6 months (P = 0.003) was found in five participants (31%). No significant changes in FSS, MSSE, MHI and IPA, in both groups, were found.


CONCLUSIONS
Although an additional effect was found, the multidisciplinary fatigue management programme showed no efficacy in reducing the impact of fatigue compared to a placebo intervention programme.
Kos
D
D
Department of Rehabilitation Research, Vrije Universiteit Brussel, Brussels, Belgium, Department of Occupational Therapy, National MS Centre, Melsbroek, Belgium. Daphne.Kos@vub.ac.be
Duportail
M
M
D'hooghe
Mb
M
Nagels
G
G
Kerckhofs
E
E
D000328:Adult; D005221:Fatigue / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000503:physiopathology* / Q000628:therapy*; D010919:Placebos; D020377:Self Efficacy; D012720:Severity of Illness Index; D016037:Single-Blind Method; D016896:Treatment Outcome
D010919:Placebos