Occupational Therapy Practice Guidelines for Adults With Multiple Sclerosis.

ABSTRACT

IMPORTANCE Occupational therapy practitioners play an important role in addressing the occupational performance and participation needs of adults with multiple sclerosis (MS) and their caregivers. OBJECTIVE: This Practice Guideline aims to help occupational therapy practitioners, as well as the people who manage, reimburse, or set policy regarding occupational therapy services, understand occupational therapy's role in providing services to adults with MS and their caregivers. This guideline can also serve as a reference for health care professionals, health care managers, educators, regulators, third-party payers, managed care organizations, and researchers. METHOD: We examined, synthesized, and integrated the results of four systematic reviews into clinical recommendations. Three systematic reviews specified occupational domains as outcomes of interest, and one focused on interventions for caregivers of people with MS. RESULTS: Twenty-one articles from the systematic reviews with strong or moderate strength of evidence served as the basis for the clinical recommendations. CONCLUSIONS AND RECOMMENDATIONS: Four interventions benefited participation in the domains of activities of daily living or sleep. Two interventions improved participation in the domain of instrumental activities of daily living. One intervention improved work participation. Two interventions benefited caregivers and the quality of the relationship between the caregiver and person with MS. Other potentially appropriate interventions or areas to address on the basis of existing or emerging evidence are discussed in the Limitations: Gaps in the Evidence and Conclusions sections. What This Article Adds This Practice Guideline provides a summary and application of the current evidence supporting occupational therapy intervention for adults with MS. It includes case examples and decision-making algorithms to support occupational therapy practitioners in addressing client goals.