REVIEW - Effectiveness of non-pharmacological interventions for fatigue in MS, RA, or SLE

[Guest guest]

J Adv Nurs. 2006 Dec;56(6):617-35.

Effectiveness of non-pharmacological interventions for fatigue in adults

with multiple sclerosis, rheumatoid arthritis, or systemic lupus

erythematosus: a systematic review.

School of Nursing and Midwifery, Flinders University, Adelaide, Australia.

jane.neill@...

AIM: This paper reports a systematic review of non-pharmacological

interventions for fatigue in adults with three common autoimmune conditions.

BACKGROUND: A considerable proportion of people with multiple sclerosis,

rheumatoid arthritis, and systemic lupus erythematosus experience

compromised quality of life due to fatigue. Recent reviews of

pharmacotherapies for fatigue in these conditions remain inconclusive, and

systematic evidence for effectiveness of non-pharmacological interventions

was unavailable. Our paper addresses this gap. METHODS: The literature

search used the key words fatigue, energy, multiple sclerosis, rheumatoid

arthritis and systemic lupus. It included 19 electronic databases and

libraries, three evidence-based journals, two internet search engines, was

dated 1987-2006, and limited to English. Non-pharmacological experimental

studies about fatigue comprising more than five adults were included.

Meta-analysis was not possible due to diverse interventions and outcome

measures, therefore studies were analysed by types of interventions used to

reduce fatigue. RESULTS: Of 653 hits, 162 papers were reviewed, and 36 met

the inclusion criteria. Thirty-three primary studies reported 14 randomized

controlled trials and 19 quasi-experimental designs. Most interventions were

tested with people with multiple sclerosis. Exercise, behavioural,

nutritional and physiological interventions were associated with

statistically significant reductions in fatigue. Aerobic exercise was

effective, appropriate and feasible for reducing fatigue among adults with

chronic autoimmune conditions. Electromagnetic field devices showed promise.

The diversity of interventions, designs, and using 24 different instruments

to measure fatigue, limited comparisons.

CONCLUSION: Low impact aerobic exercise gradually increasing in intensity,

duration and frequency may be an effective strategy in reducing fatigue in

some adults with chronic auto-immune conditions. However, fatigue is a

variable and personal experience and a range of behavioural interventions

may be required. Well-designed studies testing these promising strategies

and consensus on outcome fatigue measures are needed.

PMID: 17118041

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed & cmd=Retrieve & dopt=Abstra\

ctPlus & list_uids=17118041

Not an MD