Revisiting the management of fatigue in multiple sclerosis in the context of rehabilitation: a narrative review of current evidence

Fatigue is one of the most frequently reported symptoms of multiple sclerosis, interfering with functioning and resulting in activity limitations and participation restrictions. Therefore, it is important to manage fatigue in a rehabilitation context considering not only disability associated with impaired functioning but also all the problems relevant to environmental and personal factors as defined in the International Classification of Functioning, Disability and Health (ICF). In addition to pharmacological treatment, there are many rehabilitation interventions with evidence of effectiveness in reducing fatigue and thereby facilitating improvement, particularly in body functions and structures and activities and participation components of the ICF. However, more research is required to provide evidence for effective treatment strategies in overcoming fatigue and related problems, especially in the components of contextual factors of the ICF. International Journal of Rehabilitation Research 36:97-104 (C) 2013 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.