Occupational balance, quality of life, occupational performance, and disease-related factors in people with multiple sclerosis: A case-control study.
Araceli Ortiz-Rubio, Eva Månsson Lexell, Carita Håkansson and 1 others
Overall occupational balance was similar between people with MS and controls, but MS participants scored lower on balancing obligatory versus voluntary activities and on energy management.
Their functional independence and quality of life were lower than controls.
Key findings
1Overall occupational balance (OBQ-E total score) did not differ significantly between the MS group and controls (p = 0.05), but the MS group scored significantly lower on two items: balance between obligatory and voluntary occupations (p = 0.002) and balance between energy-giving and energy-taking occupations (p = 0.01).
2The MS group had significantly lower scores than controls on all occupational performance measures (FIM motor 72.77 vs 90.95, FIM cognitive 32.44 vs 34.98, FIM total 105.21 vs 125.93, PPT 11.98 vs 26.55; all p < 0.001) and on every EQ-5D-3L dimension and the EQ VAS (59.26 vs 82.15; all p < 0.001).
3Higher disease severity (EDSS) was weakly negatively correlated with occupational balance (rs = 0.21), and higher overall symptom burden (SymptoMScreen) was moderately negatively correlated with OB (rs = 0.32). Higher OB was weakly to moderately positively correlated with FIM motor (rs = 0.28), FIM cognitive (rs = 0.27), FIM total (rs = 0.27), and PPT (rs = 0.31).
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What it does not show
Participants were recruited through a single local patient association in Spain, and the sample was skewed toward greater disability: few were newly diagnosed, 74% used assistive devices, and 82% had regular contact with a rehabilitation unit. Findings may not generalise to people with milder MS or those without access to rehabilitation services. Controls were friends, relatives, or family members of the MS participants, which may introduce social desirability bias or shared environmental factors not present in a truly independent control group. Education level was not collected or adjusted for in the analysis, and the authors note it could be related to health literacy, rehabilitation adherence, and reported outcomes. The design is cross-sectional, so the correlations between disease severity, occupational balance, performance, and quality of life cannot be read as causal. The overall OBQ-E total score p-value was exactly 0.05, sitting at the conventional significance threshold, so the null finding for overall balance is borderline.
Declared interests
The authors declare no conflicts of interest. The study was funded by Formacion Profesorado Universitario and the University of Granada, Spain. Open access publication was funded by Universidad de Granada / CBUA.
The easy way to misread this
Do not read the non-significant overall OB score (p = 0.05) as evidence that MS does not affect occupational balance. Two specific items were significantly lower in the MS group, and the p-value sits exactly at the 0.05 threshold. Also, the sample was drawn from a patient association and skewed toward more disabled participants, so the finding that overall balance was preserved may not hold for people with milder or earlier-stage MS.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →