{ "abstract": "Background/Objectives: Multiple sclerosis (MS) frequently limits participation in daily occupations and is associated with disabling fatigue. However, the effects of occupational therapy (OT) remain uncertain because available trials have evaluated heterogeneous interventions and outcomes. This systematic review synthesized evidence from randomized controlled trials (RCTs) on occupational performance and physical and cognitive fatigue in adults with MS. Materials and Methods: Seven bibliographic databases were searched from inception to 10 August 2026: MEDLINE via PubMed, Scopus, the Cochrane Central Register of Controlled Trials (CENTRAL) via the Cochrane Library, Web of Science Core Collection, APA PsycINFO via EBSCOhost, CINAHL Complete via EBSCOhost, and ProQuest Central. Two independent reviewers performed study selection, data extraction, and risk-of-bias assessment using RoB 2. Certainty of evidence was evaluated using GRADE. Given the clinical and methodological heterogeneity, findings were synthesized narratively following the Synthesis Without Meta-Analysis guideline. The protocol was registered in PROSPERO (CRD420251115448). Results: Seven RCTs involving 488 randomized participants were included. Findings for occupational performance were inconsistent: one small waitlist-controlled trial reported large short-term benefits from occupational performance coaching, whereas an active-comparator trial found improvements in both groups without clear superiority. Other findings showed no comparative benefit or provided only indirect evidence. Fatigue findings were similarly inconsistent: one 20-participant pilot trial favored a sleep-targeted OT intervention, two trials found no comparative benefit, and one large trial transiently favored usual-care OT. The certainty of evidence was very low for both outcomes. Conclusions: The available evidence does not consistently establish that OT interventions improve occupational performance or reduce physical and cognitive fatigue in adults with MS. Larger, adequately powered RCTs using clearly defined OT interventions, standardized outcomes, and longer follow-up periods are required.", "abstract_shown": true, "affiliations": [ "School of Occupational Therapy, Faculty of Psychology, Universidad de Talca, Talca 3465548, Chile", "Centro de Investigación en Ciencias Cognitivas, Facultad de Psicología, Universidad de Talca, Talca 3465548, Chile", "VITALIS Longevity Center, Universidad de Talca, Talca 3465548, Chile", "Program in Health Promotion, Cesumar University (UniCesumar), Maringá 87050-900, Brazil", "Exercise and Rehabilitation Sciences Institute, School of Occupational Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago 8370035, Chile", "Department of Physical Activity Sciences, Universidad de Los Lagos, Osorno 5290000, Chile", "Department of Education, Faculty of Humanities, Universidad de La Serena, La Serena 1700000, Chile", "Académico Escuela de Terapia Ocupacional, Facultad de Salud y Ciencias Sociales, Universidad de Las Américas, Concepción 4030000, Chile", "Facultad de Salud, Escuela de Tecnología Médica, Universidad Santo Tomás, Los Carreras 753, Osorno 5310431, Chile", "Carrera de Terapia Ocupacional, Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Temuco 4810101, Chile", "Departamento de Medicina Interna, Facultad de Medicina, Universidad de La Frontera, Temuco 4811230, Chile", "Department of Physical Activity Sciences, Faculty of Education Sciences, Universidad Católica del Maule, Talca 3465548, Chile", "Sports Coach Career, Faculty of Life Sciences, Universidad Viña del Mar, Viña del Mar 2520000, Chile" ], "article_type": "review article", "arxiv": null, "author_total": 9, "authors": [ { "affs": [ 0, 1, 2, 3 ], "name": "Edgar Vásquez-Carrasco", "orcid": "0000-0002-5359-6587" }, { "affs": [ 3 ], "name": "Braulio Henrique Magnani Branco", "orcid": "0000-0002-4625-9128" }, { "affs": [ 4 ], "name": "Roberto Lopez-Andaur" }, { "affs": [ 5, 6 ], "name": "Jordan Hernandez-Martinez" }, { "affs": [ 7 ], "name": "Sebastián Burgos-Carrasco", "orcid": "0009-0009-4317-6165" }, { "affs": [ 8 ], "name": "Laura Ochoa-Martinez" }, { "affs": [ 9, 10 ], "name": "Cristian Sandoval-Vásquez", "orcid": "0000-0003-3184-6482" }, { "affs": [ 10 ], "name": "Francisca Peña" }, { "affs": [ 11, 12 ], "name": "Pablo Valdés-Badilla", "orcid": "0000-0002-3948-8280" } ], "bibtex": "https://research.draconitic.com/paper/0knpvqjnf30bb.bib", "cited_by": 0, "doi": "10.3390/jcm15208060", "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13706231/?tool=EBI", "id": "0knpvqjnf30bb", "issns": [ "2077-0383" ], "landing_url": "https://www.mdpi.com/2077-0383/15/20/8060", "language": "eng", "licence": "CC-BY-4.0", "licence_label": "CC BY 4.0", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [ [ "openalex", "3609|Occupational Therapy Practice and Research" ] ], "openalex": "W7222963191", "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13706231/pdf/?tool=EBI", "pmcid": "PMC13706231", "pmid": null, "published": "2026-10-01", "publisher": "MDPI AG", "ris": "https://research.draconitic.com/paper/0knpvqjnf30bb.ris", "sources": [ { "first_seen": "2026-10-30T12:20:00Z", "native_id": "10.3390/jcm15208060", "source": "crossref", "url": "https://www.mdpi.com/2077-0383/15/20/8060" }, { "first_seen": "2026-10-30T12:21:31Z", "native_id": "PMC:PMC13706231", "source": "europepmc", "url": "https://europepmc.org/article/PMC/PMC13706231" } ], "subjects": [ { "field": "medicine", "origin": "journal-openalex:F27", "subfield": "general" } ], "title": "Effects of Occupational Therapy Interventions on Occupational Performance and Physical and Cognitive Fatigue in Adults with Multiple Sclerosis: A Systematic Review of Randomized Controlled Trials", "title_text": "Effects of Occupational Therapy Interventions on Occupational Performance and Physical and Cognitive Fatigue in Adults with Multiple Sclerosis: A Systematic Review of Randomized Controlled Trials", "type": "peer-reviewed", "updated_at": "2026-10-30T12:21:31Z", "url": "https://research.draconitic.com/paper/0knpvqjnf30bb", "venue": "Journal of Clinical Medicine", "versions": [] }