Journal of Rehabilitation Research & Development (JRRD)

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Volume 48 Number 9, 2011
   Pages 1087 — 1100

Abstract —  Self-management in neurological disorders: Systematic review of the literature and potential interventions in multiple sclerosis care

Alex D. Rae-Grant, MD;1 Aaron P. Turner, PhD;2-3* Alicia Sloan, MSW, MPH;2 Deborah Miller, PhD;1 James Hunziker, ARNP;2 Jodie K. Haselkorn, MD, MPH2-4

1Mellen Center for Multiple Sclerosis Treatment and Research, Cleveland Clinic, Cleveland, OH; 2Multiple Sclerosis Center of Excellence West, Department of Veterans Affairs Puget Sound Health Care System, Seattle, WA; Departments of 3Rehabilitation Medicine and 4Epidemiology, University of Washington, Seattle, WA

Abstract — Our objective was to review the current body of evidence supporting the efficacy of self-management programs in individuals with multiple sclerosis (MS) and other chronic neurological conditions. We reviewed published literature using standardized search terms; examined self-management interventions in a variety of chronic neurological disorders, including MS; and classified studies using the evidence classification established by the American Academy of Neurology. We reviewed 527 abstracts, of which 39 met our inclusion criteria for evaluation. Of the 39 studies, 3 provided class I evidence assessing the efficacy of self-management interventions: a randomized controlled trial of a telephone counseling program for health promotion in MS, a home-based exercise program for reducing falls in people with Parkinson disease, and the comparison of a fitness center program versus a home-based exercise program for people with traumatic brain injury. The remaining studies provided additional support for self-management interventions with a lesser degree of methodologic rigor (class II, class III, or class IV evidence). We concluded that self-management strategies are applicable to chronic neurological diseases, but a need exists for more rigorous studies in this area. We provide recommendations for future intervention study methodologies with a specific emphasis on MS care.

Key words: chronic illness, headache, multiple sclerosis, neurological, Parkinson disease, self-care, self-management, stroke, systematic review, traumatic brain injury.


View HTML  ¦  View PDF  ¦  Contents Vol. 48, No. 9
This article and any supplementary material should be cited as follows:
Rae-Grant AD, Turner AP, Sloan A, Miller D, Hunziker J, Haselkorn JK. Self-management in neurological disorders: Systematic review of the literature and potential interventions in multiple sclerosis care. J Rehabil Res Dev. 2011; 48(9):1087-1100.
DOI:10.1682/JRRD.2010.08.0159
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Last Reviewed or Updated  Monday, November 21, 2011 12:00 PM

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