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The effectiveness of a self-management occupational therapy intervention on activity performance in individuals with multiple sclerosis-related fatigue

a randomized-controlled trial

Kos, Daphne; Duportail, Marijke; Meirte, Jill; Meeus, Mira; D’hooghe, Marie B.; Nagels, Guy; Willekens, Barbara; Meurrens, Tom; Ilsbroukx, Stephan; Nijs, Jo

International Journal of Rehabilitation Research: September 2016 - Volume 39 - Issue 3 - p 255–262
doi: 10.1097/MRR.0000000000000178
Original articles

Purpose to evaluate the effectiveness of an individual self-management occupational therapy intervention program (SMOoTh) versus relaxation on the performance of and satisfaction with relevant daily activities in individuals with multiple sclerosis (MS)-related fatigue. in a single-blind randomized-controlled trial, 31 patients with MS (SMOoTh: n=17, relaxation: n=14) were randomly allocated to three individual sessions focusing on pacing, prioritizing, ergonomics, and self-management (SMOoTh) or on stress management and relaxation (relaxation). Outcomes (blind assessor): Canadian Occupational Performance Measure (COPM) (primary), Modified Fatigue Impact Scale, Checklist Individual Strength and Short-Form Health Measure. COPM improved in the SMOoTh and relaxation group after the intervention and 3 months later (COPM performance: F=13.1, P=0.001 and COPM satisfaction: F=10.4, P=0.001); nonsignificant group differences showed a trend in favor of SMOoTh. Modified Fatigue Impact Scale, Checklist Individual Strength, and most of the Short-Form Health Measure subscales did not change. Clinically relevant changes in COPM performance scores were found in 71 and 27% of patients in the SMOoTh versus the relaxation group. Both interventions seem to be feasible approaches to improve performance of and satisfaction with relevant daily activities in people with MS, with a sustained effect after 3 months. Neither program altered change fatigue (impact) or quality of life. Future studies with larger sample sizes are needed.

aDepartment of Rehabilitation Sciences, KU Leuven (University of Leuven), Leuven

bDepartment of Health and Social Care, Division of Occupational Therapy, Artesis Plantijn University College Antwerp

cDepartment of Neurology, University Hospital Antwerp

dDepartment of Neurology, Translational Neurosciences, Faculty of Medicine

eDepartment of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Antwerp

fDepartment of Rehabilitation Sciences and Physiotherapy, University of Ghent, Ghent

gCenter for Neurosciences

hDepartment of Physiotherapy, Human Physiology & Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels

iNational Multiple Sclerosis Center Melsbroek, Belgium

jPain in Motion International Research Group (

Correspondence to Daphne Kos, PhD, KU Leuven, Tervuursevest 101, Box 1501, 3001 Leuven, Belgium Tel: +32 163 29177; fax: +32 16 3 29197; e-mails:,

Received February 19, 2016

Accepted April 14, 2016

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