Occupational therapy for multiple sclerosis.

E. M. Steultjens, J. Dekker, L. M. Bouter, M. Cardol, J. C. Van de Nes, C. H. Van den Ende

Research output: Contribution to JournalReview articleAcademicpeer-review

Abstract

BACKGROUND: Multiple sclerosis (MS) patients are referred to occupational therapy with complaints about fatigue, limb weakness, alteration of upper extremity fine motor coordination, loss of sensation and spasticity that causes limitations in performance of activities of daily living and social participation. The primary purpose of occupational therapy is to enable individuals to participate in self-care, work and leisure activities that they want or need to perform. OBJECTIVES: To determine whether occupational therapy interventions in MS patients improve outcome on functional ability, social participation and/or health related quality of life. SEARCH STRATEGY: Relevant full length articles were identified by electronical searches in Medline, Cinahl, Embase, Amed, Scisearch and The Cochrane MS Group Trials Register. The reference list of identified studies and reviews were examined for additional references. Date of last search: December 2002. SELECTION CRITERIA: Controlled (randomized and non-randomized) and other than controlled studies addressing occupational therapy for MS patients were eligible for inclusion. DATA COLLECTION AND ANALYSIS: The methodological quality of the included trials was independently assessed by two reviewers. Disagreements were resolved by discussion. A list proposed by Van Tulder et al. (Van Tulder 1997) was used to assess the methodological quality. For outcome measures, standardized mean differences were calculated. The results were analysed using a best-evidence synthesis based on type of design, methodological quality and the significant findings of outcome and/or process measures. MAIN RESULTS: Only one randomized clinical trial was identified. Two other included studies were a controlled clinical trial and a study with a pre-post test design. The studies included 271 patients in total. Two studies evaluated an energy-conservation course for groups of patients and one study evaluated a counselling intervention. The results of the energy conservation studies could be biased because of the designs used, the poor methodological quality and the small number of included patients. The high quality RCT on counselling reported non-significant results. REVIEWER'S CONCLUSIONS: On basis of this review no conclusions can be stated whether occupational therapy improves outcome in MS patients.The lack of (randomized controlled) efficacy studies in most intervention categories of OT shows an urgent need for future research in occupational therapy for multiple sclerosis. Initially, a survey of occupational therapy practice for MS patients including the characteristics and needs of these patients is necessary to develop a research agenda for efficacy studies.

LanguageEnglish
JournalCochrane database of systematic reviews (Online)
Issue number3
Publication statusPublished - 2003

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Occupational Therapy
Multiple Sclerosis
Social Participation
Counseling
Outcome Assessment (Health Care)
Aptitude
Process Assessment (Health Care)
Leisure Activities
Controlled Clinical Trials
Activities of Daily Living
Self Care
Upper Extremity
Fatigue
Extremities
Randomized Controlled Trials
Quality of Life

Cite this

Steultjens, E. M., Dekker, J., Bouter, L. M., Cardol, M., Van de Nes, J. C., & Van den Ende, C. H. (2003). Occupational therapy for multiple sclerosis. Cochrane database of systematic reviews (Online), (3).
Steultjens, E. M. ; Dekker, J. ; Bouter, L. M. ; Cardol, M. ; Van de Nes, J. C. ; Van den Ende, C. H. / Occupational therapy for multiple sclerosis. In: Cochrane database of systematic reviews (Online). 2003 ; No. 3.
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abstract = "BACKGROUND: Multiple sclerosis (MS) patients are referred to occupational therapy with complaints about fatigue, limb weakness, alteration of upper extremity fine motor coordination, loss of sensation and spasticity that causes limitations in performance of activities of daily living and social participation. The primary purpose of occupational therapy is to enable individuals to participate in self-care, work and leisure activities that they want or need to perform. OBJECTIVES: To determine whether occupational therapy interventions in MS patients improve outcome on functional ability, social participation and/or health related quality of life. SEARCH STRATEGY: Relevant full length articles were identified by electronical searches in Medline, Cinahl, Embase, Amed, Scisearch and The Cochrane MS Group Trials Register. The reference list of identified studies and reviews were examined for additional references. Date of last search: December 2002. SELECTION CRITERIA: Controlled (randomized and non-randomized) and other than controlled studies addressing occupational therapy for MS patients were eligible for inclusion. DATA COLLECTION AND ANALYSIS: The methodological quality of the included trials was independently assessed by two reviewers. Disagreements were resolved by discussion. A list proposed by Van Tulder et al. (Van Tulder 1997) was used to assess the methodological quality. For outcome measures, standardized mean differences were calculated. The results were analysed using a best-evidence synthesis based on type of design, methodological quality and the significant findings of outcome and/or process measures. MAIN RESULTS: Only one randomized clinical trial was identified. Two other included studies were a controlled clinical trial and a study with a pre-post test design. The studies included 271 patients in total. Two studies evaluated an energy-conservation course for groups of patients and one study evaluated a counselling intervention. The results of the energy conservation studies could be biased because of the designs used, the poor methodological quality and the small number of included patients. The high quality RCT on counselling reported non-significant results. REVIEWER'S CONCLUSIONS: On basis of this review no conclusions can be stated whether occupational therapy improves outcome in MS patients.The lack of (randomized controlled) efficacy studies in most intervention categories of OT shows an urgent need for future research in occupational therapy for multiple sclerosis. Initially, a survey of occupational therapy practice for MS patients including the characteristics and needs of these patients is necessary to develop a research agenda for efficacy studies.",
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Steultjens, EM, Dekker, J, Bouter, LM, Cardol, M, Van de Nes, JC & Van den Ende, CH 2003, 'Occupational therapy for multiple sclerosis.', Cochrane database of systematic reviews (Online), no. 3.

Occupational therapy for multiple sclerosis. / Steultjens, E. M.; Dekker, J.; Bouter, L. M.; Cardol, M.; Van de Nes, J. C.; Van den Ende, C. H.

In: Cochrane database of systematic reviews (Online), No. 3, 2003.

Research output: Contribution to JournalReview articleAcademicpeer-review

TY - JOUR

T1 - Occupational therapy for multiple sclerosis.

AU - Steultjens, E. M.

AU - Dekker, J.

AU - Bouter, L. M.

AU - Cardol, M.

AU - Van de Nes, J. C.

AU - Van den Ende, C. H.

PY - 2003

Y1 - 2003

N2 - BACKGROUND: Multiple sclerosis (MS) patients are referred to occupational therapy with complaints about fatigue, limb weakness, alteration of upper extremity fine motor coordination, loss of sensation and spasticity that causes limitations in performance of activities of daily living and social participation. The primary purpose of occupational therapy is to enable individuals to participate in self-care, work and leisure activities that they want or need to perform. OBJECTIVES: To determine whether occupational therapy interventions in MS patients improve outcome on functional ability, social participation and/or health related quality of life. SEARCH STRATEGY: Relevant full length articles were identified by electronical searches in Medline, Cinahl, Embase, Amed, Scisearch and The Cochrane MS Group Trials Register. The reference list of identified studies and reviews were examined for additional references. Date of last search: December 2002. SELECTION CRITERIA: Controlled (randomized and non-randomized) and other than controlled studies addressing occupational therapy for MS patients were eligible for inclusion. DATA COLLECTION AND ANALYSIS: The methodological quality of the included trials was independently assessed by two reviewers. Disagreements were resolved by discussion. A list proposed by Van Tulder et al. (Van Tulder 1997) was used to assess the methodological quality. For outcome measures, standardized mean differences were calculated. The results were analysed using a best-evidence synthesis based on type of design, methodological quality and the significant findings of outcome and/or process measures. MAIN RESULTS: Only one randomized clinical trial was identified. Two other included studies were a controlled clinical trial and a study with a pre-post test design. The studies included 271 patients in total. Two studies evaluated an energy-conservation course for groups of patients and one study evaluated a counselling intervention. The results of the energy conservation studies could be biased because of the designs used, the poor methodological quality and the small number of included patients. The high quality RCT on counselling reported non-significant results. REVIEWER'S CONCLUSIONS: On basis of this review no conclusions can be stated whether occupational therapy improves outcome in MS patients.The lack of (randomized controlled) efficacy studies in most intervention categories of OT shows an urgent need for future research in occupational therapy for multiple sclerosis. Initially, a survey of occupational therapy practice for MS patients including the characteristics and needs of these patients is necessary to develop a research agenda for efficacy studies.

AB - BACKGROUND: Multiple sclerosis (MS) patients are referred to occupational therapy with complaints about fatigue, limb weakness, alteration of upper extremity fine motor coordination, loss of sensation and spasticity that causes limitations in performance of activities of daily living and social participation. The primary purpose of occupational therapy is to enable individuals to participate in self-care, work and leisure activities that they want or need to perform. OBJECTIVES: To determine whether occupational therapy interventions in MS patients improve outcome on functional ability, social participation and/or health related quality of life. SEARCH STRATEGY: Relevant full length articles were identified by electronical searches in Medline, Cinahl, Embase, Amed, Scisearch and The Cochrane MS Group Trials Register. The reference list of identified studies and reviews were examined for additional references. Date of last search: December 2002. SELECTION CRITERIA: Controlled (randomized and non-randomized) and other than controlled studies addressing occupational therapy for MS patients were eligible for inclusion. DATA COLLECTION AND ANALYSIS: The methodological quality of the included trials was independently assessed by two reviewers. Disagreements were resolved by discussion. A list proposed by Van Tulder et al. (Van Tulder 1997) was used to assess the methodological quality. For outcome measures, standardized mean differences were calculated. The results were analysed using a best-evidence synthesis based on type of design, methodological quality and the significant findings of outcome and/or process measures. MAIN RESULTS: Only one randomized clinical trial was identified. Two other included studies were a controlled clinical trial and a study with a pre-post test design. The studies included 271 patients in total. Two studies evaluated an energy-conservation course for groups of patients and one study evaluated a counselling intervention. The results of the energy conservation studies could be biased because of the designs used, the poor methodological quality and the small number of included patients. The high quality RCT on counselling reported non-significant results. REVIEWER'S CONCLUSIONS: On basis of this review no conclusions can be stated whether occupational therapy improves outcome in MS patients.The lack of (randomized controlled) efficacy studies in most intervention categories of OT shows an urgent need for future research in occupational therapy for multiple sclerosis. Initially, a survey of occupational therapy practice for MS patients including the characteristics and needs of these patients is necessary to develop a research agenda for efficacy studies.

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Steultjens EM, Dekker J, Bouter LM, Cardol M, Van de Nes JC, Van den Ende CH. Occupational therapy for multiple sclerosis. Cochrane database of systematic reviews (Online). 2003;(3).