Cognitive and physical fatigue are associated with distinct problems in daily functioning, role fulfilment, and quality of life in multiple sclerosis., Multiple Sclerosis and Related Disorders (2019), doi:

Introduction: Fatigue substantially affects the lives of many people with multiple sclerosis. This study aimed to further our understanding of the experience of living with multiple sclerosis fatigue by exploring how people became aware of and understood their multiple sclerosis fatigue and how they accommodate it in their daily lives. Method: The study used an existential approach to thematic analysis. Thirteen in-depth, semi-structured interviews with people who experienced multiple sclerosis fatigue were conducted and analysed. Results: Participants developed an understanding of multiple sclerosis fatigue through gaining awareness of its effect on their lives, seeking information themselves and being informed by health professionals. Participants described how they began to understand the effect of fatigue in their lives and make decisions about how to accommodate it. They discussed the challenges associated with helping others to understand their multiple sclerosis fatigue. Conclusion: Lay and expert explanations, the phenomenological notions of lived experience, self-identity and embodiment and stigma associated with invisible disability were useful concepts for understanding the results. Clinicians should consider these concepts when supporting people with multiple sclerosis fatigue to understand the effect of fatigue in their daily lives and use fatigue management strategies to make effective lifestyle changes to accommodate it.

Introduction Physical inactivity is a leading risk factor to disease and mortality. Despite the recognised benefits of physical activity, over half of the Australian population are not sufficiently active. For individuals with a disability, inactivity rates are further increased placing them at a higher risk of the negative effects of physical inactivity. Developing healthy lifestyle habits such as physical activity participation in early childhood has been found to be supportive of health behaviours being maintained into adulthood. Physical activity is an occupation said to involve the complex interaction between psychological, social, environmental, and physical factors placing it within the scope of occupation therapy. However, limited research is available exploring what this role looks like in practice. Method An online, anonymous survey was developed to better understand how Australian occupational therapists understood physical activity participation, as well as their current and potential role in facilitating regular physical activity participation with their clients. All registered Australian occupational therapists were eligible to participate in this survey, which consisted of both closed and open answered questions. Results A total of 43 occupational therapists registered to practice within Australia completed the survey. All participants viewed physical activity as an important occupation for maintaining the health and well‐being of their clients. Participants described the holistic role occupational therapists could play supporting physical activity participation outside of motor skill development. Therapists identified several ways in which a family‐centred, occupation‐based approach could be used to support sustained engagement in physical activity. Conclusion The findings from this study contribute to our understanding of the role occupational therapy can play supporting physical activity participation for children and adolescents. This sparsely researched area requires more evaluation to ensure intervention is delivered in a way that is most effective.

Background. Parkinson's disease (PD) leads to cognitive dysfunction which limits participation and occupational performance. Cognitive Orientation to Daily Occupational Performance (CO-OP) approach is effective in other adult neurological populations and warrants investigation in PD. Purpose. To describe a study protocol evaluating the preliminary efficacy and feasibility of CO-OP approach in PD. Method. A randomised controlled trial (RCT) with adults with PD was assigned to either: CO-OP training-intensive (CO-OP-I, 20 sessions) or waitlist control (WLC) followed by CO-OP-standard (CO-OP-S, 10 sessions). Outcomes. Occupational performance and satisfaction of adults with PD in chosen goals. Measures will be obtained at baseline, post-intervention, and 3-month follow-up. Implications. As the first RCT focused on CO-OP in PD, this trial will provide evidence for the potential of this approach in PD and lay the groundwork for future large-scale trials. Trial Registration. New Zealand Clinical Trials Registry, ACTRN12621001483842. Registered November 1, 2021; retrospectively registered 3 months after commencement.

People with Multiple Sclerosis (MS) undertake insufficient physical activity based on current guidelines. Recent work points to the benefits of increasing the amount of time spent in all non-sedentary physical activity. The current study sought to explore the potential benefits to community participation, as well as examine factors predictive, of engagement in 'habitual' and/or low-intensity physical activity. Seventy-four people with MS were compared to 67 healthy controls using the Frenchay Activities Index (FAI). Findings revealed differences in habitual activity level (p < .001), and low-intensity physical activity (p < .001), with people with MS having a lower level of engagement than healthy people. After controlling for the impact of MS on mobility, years since symptom onset, physical fatigue and reduced positive affect were the most significant predictors of engagement in 'at least weekly' low-intensity physical activity. Higher frequency of low-intensity physical activity was significantly associated with greater home, social and occupational participation (all p < .05), and physical health status (p < .01), but not mental health status (p = .964) in people with MS. Results suggest that improving habitual activity level and engagement in low-intensity physical activity may be of benefit for people with MS.