Rehabilitation Interventions to Support Fatigue Management in Multiple Sclerosis

Background: Fatigue is a prevalent and debilitating symptom of MS that significantly impacts quality of life. Despite growing evidence to support rehabilitation interventions for MS fatigue management, no comprehensive guideline exists to bridge the gap between research and clinical practice. To address this, MSBEST, in partnership with MS Canada and the Canadian Network of MS Clinics, is developing the first comprehensive MS Rehab Best Practice Guideline. This work pertains to the chapter on fatigue management. As an initial step, an umbrella review was conducted to identify and critically appraise existing systematic reviews and meta-analyses regarding rehabilitation interventions for MS fatigue.

Methods: Multiple databases were searched to identify relevant articles. Citations were imported into Covidence and independantly reviewed for inclusion by two assessors. Data extraction and quality assessment was also carried out by two independant reviewers. At every step, a third member was involved to resolve disagreements.

Results: 111 studies were included for data extraction. Data extraction is complete; however, analysis is currently ongoing. Existing literature primarily covers exercise and psychological/cognitive interventions, with significantly variability intervention types, dosage, timing, and delivery methods.

Conclusion: The results from this umbrella review will inform future guideline development.