Occupational Therapy for the Management of Fatigue in Multiple Sclerosis

A fatigue management programme for clients with multiple sclerosis has been developed as part of the occupational therapy service at the National Hospital for Neurology and Neurosurgery.* A single case study approach was used to evaluate the effectiveness of the fatigue management programme during a 3-week period of inpatient rehabilitation.

The assessments used were, first, objective measures of productivity and, secondly, client rating of performance, satisfaction and level of fatigue, associated with the performance of a keyboard activity chosen by the client. The activity was performed and the assessments were made during four sessions in the baseline phase (first week) and repeated in the third week. The fatigue management programme was carried out in the second week.

The ratings of performance and satisfaction after the task were initially varied but became more consistent when fatigue management was applied. Also, a downwards trend (more exhausted) in the level of fatigue ratings recorded in the baseline was reversed (less tired). Productivity improved up to 100% of the task.

The main conclusion was an overall change to more consistent levels of task performance which had a positive impact on the experience of fatigue. Further work is required to evaluate generalisation to other tasks and the carry-over to the community setting.