A 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.

For 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 results.

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.

This systematic review is published online in Archives of Physical Medicine and Rehabilitation.