Multiple Sclerosis Journal - October 2017 - 1534

Multiple Sclerosis Journal 23(11)

Figure 2. Graphs of the observed data on the primary outcomes CIS20r fatigue and five IPA domains.
Solid line: energy conservation management (ECM) intervention group; dashed line: Information-only control group; small dotted line:
value of severe fatigue CIS20r⩾35. CIS20r - Checklist Individual Strength, subscale subjective fatigue: higher scores reflect worse
fatigue; IPA - Impact on Participation and Autonomy: higher scores reflect more barriers to participation and autonomy.

other hand, the 8-point threshold has been cited in
several studies18,35 as a clinically relevant decrease in
fatigue. Another approach to detecting clinically relevant effects of an intervention is to use the CIS20r
fatigue subscale threshold of 35 as an indicator of
severe fatigue. In our study, the mean fatigue score
was never below 35, confirming the ineffectiveness of
ECM both between groups and within the group.
With the exception of a small negative effect of ECM
on the IPA domain social relations, the other IPA
domains showed no intervention effects, in agreement
1534

with results reported by Rietberg et al.7 who compared a multidisciplinary intervention, including
energy management, with MS nurse consultations.
One explanation might be that our study population
already experienced few restrictions to participation
and autonomy. The negative impact of ECM on the
social relations may be related to a greater awareness,
due to the treatment, among ECM participants, which
may have resulted in a more critical frame of mind. In
contrast to our study, other studies have shown
improvements of ECM on several domains of the
SF-36,10,11 compared to a waitlist control group.
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Table of Contents for the Digital Edition of Multiple Sclerosis Journal - October 2017

Contents
Multiple Sclerosis Journal - October 2017 - Cover1
Multiple Sclerosis Journal - October 2017 - Cover2
Multiple Sclerosis Journal - October 2017 - Contents
Multiple Sclerosis Journal - October 2017 - ii
Multiple Sclerosis Journal - October 2017 - iii
Multiple Sclerosis Journal - October 2017 - 1436
Multiple Sclerosis Journal - October 2017 - 1437
Multiple Sclerosis Journal - October 2017 - 1438
Multiple Sclerosis Journal - October 2017 - 1439
Multiple Sclerosis Journal - October 2017 - 1440
Multiple Sclerosis Journal - October 2017 - 1441
Multiple Sclerosis Journal - October 2017 - 1442
Multiple Sclerosis Journal - October 2017 - 1443
Multiple Sclerosis Journal - October 2017 - 1444
Multiple Sclerosis Journal - October 2017 - 1445
Multiple Sclerosis Journal - October 2017 - 1446
Multiple Sclerosis Journal - October 2017 - 1447
Multiple Sclerosis Journal - October 2017 - 1448
Multiple Sclerosis Journal - October 2017 - 1449
Multiple Sclerosis Journal - October 2017 - 1450
Multiple Sclerosis Journal - October 2017 - 1451
Multiple Sclerosis Journal - October 2017 - 1452
Multiple Sclerosis Journal - October 2017 - 1453
Multiple Sclerosis Journal - October 2017 - 1454
Multiple Sclerosis Journal - October 2017 - 1455
Multiple Sclerosis Journal - October 2017 - 1456
Multiple Sclerosis Journal - October 2017 - 1457
Multiple Sclerosis Journal - October 2017 - 1458
Multiple Sclerosis Journal - October 2017 - 1459
Multiple Sclerosis Journal - October 2017 - 1460
Multiple Sclerosis Journal - October 2017 - 1461
Multiple Sclerosis Journal - October 2017 - 1462
Multiple Sclerosis Journal - October 2017 - 1463
Multiple Sclerosis Journal - October 2017 - 1464
Multiple Sclerosis Journal - October 2017 - 1465
Multiple Sclerosis Journal - October 2017 - 1466
Multiple Sclerosis Journal - October 2017 - 1467
Multiple Sclerosis Journal - October 2017 - 1468
Multiple Sclerosis Journal - October 2017 - 1469
Multiple Sclerosis Journal - October 2017 - 1470
Multiple Sclerosis Journal - October 2017 - 1471
Multiple Sclerosis Journal - October 2017 - 1472
Multiple Sclerosis Journal - October 2017 - 1473
Multiple Sclerosis Journal - October 2017 - 1474
Multiple Sclerosis Journal - October 2017 - 1475
Multiple Sclerosis Journal - October 2017 - 1476
Multiple Sclerosis Journal - October 2017 - 1477
Multiple Sclerosis Journal - October 2017 - 1478
Multiple Sclerosis Journal - October 2017 - 1479
Multiple Sclerosis Journal - October 2017 - 1480
Multiple Sclerosis Journal - October 2017 - 1481
Multiple Sclerosis Journal - October 2017 - 1482
Multiple Sclerosis Journal - October 2017 - 1483
Multiple Sclerosis Journal - October 2017 - 1484
Multiple Sclerosis Journal - October 2017 - 1485
Multiple Sclerosis Journal - October 2017 - 1486
Multiple Sclerosis Journal - October 2017 - 1487
Multiple Sclerosis Journal - October 2017 - 1488
Multiple Sclerosis Journal - October 2017 - 1489
Multiple Sclerosis Journal - October 2017 - 1490
Multiple Sclerosis Journal - October 2017 - 1491
Multiple Sclerosis Journal - October 2017 - 1492
Multiple Sclerosis Journal - October 2017 - 1493
Multiple Sclerosis Journal - October 2017 - 1494
Multiple Sclerosis Journal - October 2017 - 1495
Multiple Sclerosis Journal - October 2017 - 1496
Multiple Sclerosis Journal - October 2017 - 1497
Multiple Sclerosis Journal - October 2017 - 1498
Multiple Sclerosis Journal - October 2017 - 1499
Multiple Sclerosis Journal - October 2017 - 1500
Multiple Sclerosis Journal - October 2017 - 1501
Multiple Sclerosis Journal - October 2017 - 1502
Multiple Sclerosis Journal - October 2017 - 1503
Multiple Sclerosis Journal - October 2017 - 1504
Multiple Sclerosis Journal - October 2017 - 1505
Multiple Sclerosis Journal - October 2017 - 1506
Multiple Sclerosis Journal - October 2017 - 1507
Multiple Sclerosis Journal - October 2017 - 1508
Multiple Sclerosis Journal - October 2017 - 1509
Multiple Sclerosis Journal - October 2017 - 1510
Multiple Sclerosis Journal - October 2017 - 1511
Multiple Sclerosis Journal - October 2017 - 1512
Multiple Sclerosis Journal - October 2017 - 1513
Multiple Sclerosis Journal - October 2017 - 1514
Multiple Sclerosis Journal - October 2017 - 1515
Multiple Sclerosis Journal - October 2017 - 1516
Multiple Sclerosis Journal - October 2017 - 1517
Multiple Sclerosis Journal - October 2017 - 1518
Multiple Sclerosis Journal - October 2017 - 1519
Multiple Sclerosis Journal - October 2017 - 1520
Multiple Sclerosis Journal - October 2017 - 1521
Multiple Sclerosis Journal - October 2017 - 1522
Multiple Sclerosis Journal - October 2017 - 1523
Multiple Sclerosis Journal - October 2017 - 1524
Multiple Sclerosis Journal - October 2017 - 1525
Multiple Sclerosis Journal - October 2017 - 1526
Multiple Sclerosis Journal - October 2017 - 1527
Multiple Sclerosis Journal - October 2017 - 1528
Multiple Sclerosis Journal - October 2017 - 1529
Multiple Sclerosis Journal - October 2017 - 1530
Multiple Sclerosis Journal - October 2017 - 1531
Multiple Sclerosis Journal - October 2017 - 1532
Multiple Sclerosis Journal - October 2017 - 1533
Multiple Sclerosis Journal - October 2017 - 1534
Multiple Sclerosis Journal - October 2017 - 1535
Multiple Sclerosis Journal - October 2017 - 1536
Multiple Sclerosis Journal - October 2017 - 1537
Multiple Sclerosis Journal - October 2017 - 1538
Multiple Sclerosis Journal - October 2017 - 1539
Multiple Sclerosis Journal - October 2017 - 1540
Multiple Sclerosis Journal - October 2017 - 1541
Multiple Sclerosis Journal - October 2017 - 1542
Multiple Sclerosis Journal - October 2017 - 1543
Multiple Sclerosis Journal - October 2017 - 1544
Multiple Sclerosis Journal - October 2017 - 1545
Multiple Sclerosis Journal - October 2017 - 1546
Multiple Sclerosis Journal - October 2017 - 1547
Multiple Sclerosis Journal - October 2017 - 1548
Multiple Sclerosis Journal - October 2017 - 1549
Multiple Sclerosis Journal - October 2017 - 1550
Multiple Sclerosis Journal - October 2017 - 1551
Multiple Sclerosis Journal - October 2017 - 1552
Multiple Sclerosis Journal - October 2017 - 1553
Multiple Sclerosis Journal - October 2017 - 1554
Multiple Sclerosis Journal - October 2017 - 1555
Multiple Sclerosis Journal - October 2017 - 1556
Multiple Sclerosis Journal - October 2017 - 1557
Multiple Sclerosis Journal - October 2017 - 1558
Multiple Sclerosis Journal - October 2017 - 1559
Multiple Sclerosis Journal - October 2017 - 1560
Multiple Sclerosis Journal - October 2017 - 1561
Multiple Sclerosis Journal - October 2017 - 1562
Multiple Sclerosis Journal - October 2017 - 1563
Multiple Sclerosis Journal - October 2017 - 1564
Multiple Sclerosis Journal - October 2017 - 1565
Multiple Sclerosis Journal - October 2017 - 1566
Multiple Sclerosis Journal - October 2017 - Cover3
Multiple Sclerosis Journal - October 2017 - Cover4
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