Multiple Sclerosis Journal - October 2017 - 1538

Multiple Sclerosis Journal 23(11)
Table 6. (Continued)
Crude model

SF-36 Mental
health

RAP
Communication

RAP Mobility

RAP Self-care

RAP Occupation

RAP
Relationships

T8
T16
T26
T52
T8
T16
T26
T52
T8
T16
T26
T52
T8
T16
T26
T52
T8
T16
T26
T52
T8
T16
T26
T52

Adjusted modela

B

p

95% CI

−0.59
1.06
1.73
0.49
−0.03
0.04
0.15
−0.12
−0.31
0.20
0.37
0.59
0.20
−0.45
0.14
−0.48
−0.82
0.15
−0.01
−0.29
−0.32
−0.20
0.24
−0.12

0.85
0.74
0.59
0.88
0.83
0.72
0.24
0.32
0.43
0.63
0.37
0.15
0.44
0.23
0.70
0.21
0.01
0.63
0.99
0.37
0.20
0.45
0.36
0.63

−6.75
−5.25
−4.58
−5.88
−0.26
−0.20
−0.10
−0.37
−1.10
−0.60
−0.44
−0.21
−0.44
−1.19
−0.59
−1.22
−1.43
−0.48
−0.64
−0.93
−0.82
−0.71
−0.28
−0.64

5.57
7.36
8.03
6.86
0.21
0.29
0.39
0.12
0.47
1.00
1.17
1.39
1.01
0.28
0.88
0.26
−0.20
0.79
0.63
0.34
0.17
0.32
0.75
0.39

B

p

−0.58
1.19
1.81
0.56
−0.02
0.05
0.15
−0.12
−0.28
0.24
0.40
0.62
0.31
−0.43
0.15
−0.45
−0.78
0.17
0.01
−0.27
−0.32
−0.19
0.24
−0.13

0.86
0.71
0.58
0.86
0.85
0.69
0.24
0.34
0.49
0.57
0.34
0.13
0.49
0.25
0.68
0.23
0.01
0.60
0.97
0.40
0.20
0.47
0.37
0.63

95% CI
−6.84
−5.23
−4.61
−5.92
−0.26
−0.20
−0.10
−0.37
−1.08
−0.58
−0.42
−0.19
−0.41
−1.17
−0.58
−1.19
−1.39
−0.46
−0.61
−0.90
−0.82
−0.71
−0.28
−0.65

5.68
7.62
8.23
7.05
0.22
0.30
0.40
0.13
0.52
1.06
1.21
1.44
1.02
0.30
0.89
0.28
−0.17
0.79
0.64
0.36
0.18
0.33
0.75
0.39

CI: confidence interval; CIS20r: Checklist Individual Strength: higher scores indicate greater impact of fatigue on concentration,
motivation or activity; MFIS: Modified Fatigue Impact Scale: higher scores indicate greater impact of fatigue; FSS: Fatigue Severity
Scale: higher scores reflect more severe fatigue; SF-36: health-related quality of life: higher scores reflect a more favourable health
status or a higher vitality; RAP: Rehabilitation Activities Profile.
aAdjusted for centre, gender, exacerbations and time since diagnosis.

The findings of our RCT have clinical implications
because ECM was not more effective for reducing
fatigue compared to the information-only control
condition. Although the decline within the ECM
group approached a clinically relevant change, on
average, participants still remained severely fatigued.
However, some patients improved more than others,
and future analyses will focus on factors that mediated the effects of ECM. An important result of this
study is that the participants appreciate the given
strategies and perceived those as useful, so ECM
seems to have a subjective good effect for fatigued
persons with MS. Furthermore, it is known that
TREFAMS-CBT protocol (submitted) has significant
effect on fatigue on the short term. Therefore, a combination of ECM and CBT to get an even more powerful intervention to reduce fatigue in persons with
MS may be useful.

1538

Acknowledgements
L.J.M.B. is the guarantor and contributed to writing
the paper, analysis and interpretation of data. J.v.M.
contributed to conception and design of the study,
inclusion of patients, interpretation of data, co-writing
and final approval of the version to be published.
J.W.R.T. contributed to analysis and interpretation of
data and co-writing on statistical analysis and final
approval of the version to be published. F.A.J.d.L.
contributed to implementation of the study design,
inclusion of patients, revising article critically for
important intellectual content and final approval of the
version to be published. V.d.G. contributed to initiating and design of the study, obtaining funding,
TREFAMS-ACE programme coordination, revising
article critically for important intellectual content and
final approval of the version to be published. H.B.
contributed to initiating and design of the study,

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Table of Contents for the Digital Edition of Multiple Sclerosis Journal - October 2017
