Psychosocial interventions in people with multiple sclerosis

Abstract

Thirty-three studies fulfilled the inclusion criteria; however, interventions varied widely in content, delivery and duration. Furthermore, failure to report full methodological details, as well as weaknesses in study design, reduced the strength of inferences that could be drawn from these studies. These notwithstanding, there were three studies of sufficient quality to provide some evidence regarding the value of education/information, goal setting, homework assignments, exercise, discussion forums and multidisciplinary team support. Thus, this review has identified the potential benefit of the aforementioned activities in the psychosocial management of this population. However, further well designed clinical trials are warranted to determine, definitively, the effectiveness, or otherwise, of these components.

Chiropractic Treatment of Pregnancy-Related Low Back Pain: A Systematic Review of the Evidence

“…The Oswestry Disability Index is a frequently used and well-studied tool found to be valid, reliable, and responsive, and its use as a standardized outcome measure to measure functional status has been advocated by numerous experts. [42][43][44] Quality of life or generic health and well-being could also be measured using one of the SF-36, SF-12, or EuroQoL. 44 Regardless of the outcome measures used, it is important for researchers to define primary end points, such as what distinguishes a clinically important improvement in back pain, disability due to back pain, quality of life, etc.…”

Effectiveness of Rehabilitation in Enhancing Community Integration After Acute Traumatic Brain Injury: A Systematic Review

“…Downs and Black (1998) stated that health care research must use a nonrandomized method and a checklist for non-RCT studies because current checklists lack detailed subscales and ignore the external validity of trials. Their checklist is now used for systematic reviews in rehabilitation (McCabe et al, 2007;Robbins, Houghton, Woodbury, & Brown, 2006;Teasell et al, 2007) and other fields (Hartling, Brison, Crumley, Klassen, & Pickett, 2004;Malcomson, Dunwoody, & Lowe-Strong, 2007). The Downs and Black checklist consists of 27 questions with four subscales: Reporting, External Validity, Bias, and Confounding.…”

The Effect of Biofeedback as a Psychological Intervention in Multiple Sclerosis: A Randomized Controlled Study

“…2,3,5,7 While offering hope that nonpharmacologic psychological or psychosocial interventions can improve health outcomes in MS, their effect may be due to the patient's placing an emphasis or developing dependence on the treatment (or therapist or group) rather than developing self-regulation or an internal locus of control.…”

“…21 In that study, mean fatigue was ment, including evaluation of the effectiveness of group treatment with cognitive-behavioral therapy (CBT) 8 ; bibliotherapy, psychotherapy, and social discussion 5,7 ; mindfulness meditation 2 ; and individual stress-reduction therapy. 3 Each study found improvements across outcome measures such as disease progression, fatigue, quality of life, and depression.…”

“…2,3 No standardized guidelines exist for effective management of the high levels of fatigue, depression, or stress found in association with MS, despite wide reporting of these symptoms. [3][4][5][6][7] Recent controlled studies within MS populations have addressed psychosocial aspects of health manage-relaxation, mindfulness, social support, and education (RMSSE) in improving self-regulation, measured by breathing rate and muscle tension. Improved self-regulation may increase internal control beliefs through the use of biofeedback, causing reductions in self-reported anxiety, stress, fatigue, and depression and changes in self-reported coping style.…”