Effect Of Occupational Therapy On Resilience and Quality Of Life In MS

Background: Resilience is the capacity for positive adaptation in response to stress or adversity, which plays an important role in functional recovery and health related quality of life (HRQOL). There is limited research available on resilience in the MS population. Occupational therapy (OT) focuses on mitigating symptoms that are causing functional impairment and may therefore increase resilience and HRQOL.

Objectives: To measure the impact of OT on resilience and HRQOL in clients with MS; To determine the relationship between resilience and HQQOL.

Methods: 34 subjects with confirmed MS participated; 18 experimental subjects received OT (experimental) for a period of 6-8 weeks and 16 MS subjects (controls) did not receive OT intervention. At baseline and at study completion, all subjects completed the Resilience Scale (RS) and the Multiple Sclerosis Impact Scale (MSIS-29). 8 weeks of OT intervention focused on symptom management and functional independence in daily activities.

Results: In the experimental group (n=18), total scores for both resilience and HRQOL improved significantly (p≤.001 with large effect sizes). In contrast, control subjects (n=16) showed less robust improvement in resilience (p<.05, with a small effect size) and no change in HRQOL. Correlations were computed to determine if there was a relationship between the RS and the MSIS-29 but no significant correlations were found. For the control group, neither the pre- or post-test scores between the RS and the MSIS-29 correlated. For the experimental group, only the post RS and MSIS-29 scores correlated (p<.05, with a small effect size). While this may suggest little relationship between resilience and HRQOL, it is important to consider the impact of the psychological and physical subscales of the MSIS-29, as researchers have suggested that the subscale scores have more validity for HRQOL than the total score. Analysis of the psychological and physical subscales of the MSIS-29 and the relationship of these subscales to resilience is currently being performed and will be presented.

Conclusions: OT may improve resilience and HRQOL of individuals with MS. Resilience and HRQOL may be independent of one another despite the fact that both may associated with positive adjustment to MS.