What is the effect of education on fatigue in adults with neurological conditions? A systematic review and meta-analysis.
Alex Delbridge, Owen Howlett, Coralie English and 1 others
PMID 40545627WHAT IT FOUND
Fatigue education produced a small but significant reduction in fatigue for people with neurological conditions, with the strongest effect seen in one-to-one delivery.
For stroke specifically, the effect was negligible. Evidence certainty is low.
Key findings
01Education programs produced a small but statistically significant reduction in fatigue across all neurological conditions (SMD −0.28; 95% CI −0.45 to −0.11), with low certainty of evidence.
02One-to-one delivery showed a small significant effect (SMD −0.44; 95% CI −0.77 to −0.12) while group delivery showed a negligible effect (SMD −0.17; 95% CI −0.36 to 0.01).
03No significant effect was found for people with stroke (SMD −0.08; 95% CI −0.31 to 0.15), while a small significant effect was found for people with multiple sclerosis (SMD −0.37; 95% CI −0.59 to −0.15).
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
All trials had high risk of bias for blinding of participants and personnel, which is inherent to education interventions, and 53% did not clearly report whether outcome assessors were blinded. The overall certainty of evidence is low due to significant heterogeneity across trial results. Fourteen of the nineteen trials involved people with multiple sclerosis, so the findings may not generalise well to stroke, Parkinson's disease, or other neurological conditions. Only immediate post-intervention scores were analysed; the sustained benefit of fatigue education beyond the intervention period is unknown. The review could not compare the relative effectiveness of different educational or behaviour change approaches because trials did not report their components in sufficient detail. Publication bias was not formally assessed with a funnel plot or Egger's test.
Declared interests
The authors received no financial support for the research, authorship, or publication and declared no potential conflicts of interest.
The easy way to misread this
Do not read this as evidence that fatigue education will help your stroke patients. The three stroke trials showed no significant effect (SMD −0.08; 95% CI −0.31 to 0.15), while the significant overall effect came from a pool that included fourteen multiple sclerosis trials.
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 →