new systematic review provides evidence that, in the short term, energy
conservation management (ECM) treatment can be more effective than no treatment
in reducing the impact of fatigue and improving quality of life in patients
with multiple sclerosis-related fatigue.
this review, the authors searched PubMed, CINAHL, EMBASE, and Web of Knowledge
to identify relevant randomized controlled trials (RCTs) and controlled
clinical trials. To select potential studies, 2 reviewers independently applied
the inclusion criteria. Two reviewers independently extracted data and assessed
the methodological quality of the studies included. If meta-analysis was not
possible, qualitative best-evidence synthesis was used to summarize 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 quality
of life (QoL); 1 study reported short- and mid-term 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, physical, and psychosocial;
and (2) SF-36: role physical, social function, and mental health. Limited or no
evidence was found for the effectiveness of ECM treatment on the other outcomes
in the short- or mid-term. None of the studies reported long-term results.
is published online in Archives of
Physical Medicine and Rehabilitation.