{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T07:31:16Z","timestamp":1786692676289,"version":"build-2736575974"},"reference-count":43,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2022,6,24]],"date-time":"2022-06-24T00:00:00Z","timestamp":1656028800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"US Army Medical Research and Material Command","award":["W81XWH-10-1-0920"],"award-info":[{"award-number":["W81XWH-10-1-0920"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["American Journal of Occupational Therapy"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:p>\n                    <jats:bold>Importance:<\/jats:bold>\n                    Fatigue is a chronic and distressing sequela of traumatic brain injury (TBI). Little evidence exists for the efficacy of interventions that address post-TBI fatigue.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Objective:<\/jats:bold>\n                    To evaluate the preliminary efficacy of a self-management intervention (Maximizing Energy; MAX) for reducing the impact (primary outcome) and severity of fatigue on daily life, improving fatigue experience, and increasing participation compared with a health education (HE) intervention.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Design:<\/jats:bold>\n                    Pilot randomized controlled trial (RCT).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Setting:<\/jats:bold>\n                    Community.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Participants:<\/jats:bold>\n                    Forty-one participants randomly assigned to the MAX (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 20) or HE (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 21) intervention.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Interventions:<\/jats:bold>\n                    The MAX intervention included problem-solving therapy with energy conservation education to teach participants fatigue management. The HE intervention included diet, exercise, and energy conservation education. Both interventions (30 min\/day, 2 days\/wk for 8 wk) were delivered online by occupational therapists.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Outcome and Measures:<\/jats:bold>\n                    The primary outcome was the modified Fatigue Impact Scale (mFIS). Outcome measures were collected at baseline, postintervention, and 4- and 8-wk postintervention.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:<\/jats:bold>\n                    At 8 wk postintervention, participants in the MAX group reported significantly lower levels of fatigue impact (mFIS) than those in the HE group,\n                    <jats:italic toggle=\"yes\">F<\/jats:italic>\n                    (1, 107) = 29.54,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    = .01; Cohen\u2019s\n                    <jats:italic toggle=\"yes\">d<\/jats:italic>\n                    = 0.87; 95% confidence interval [0.18, 1.55].\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusions and Relevance:<\/jats:bold>\n                    These findings provide preliminary evidence that the MAX intervention may decrease the impact of fatigue on daily life among people with post-TBI fatigue.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>What This Article Adds:<\/jats:bold>\n                    An internet-based, self-management intervention combining occupational therapy\u2013 delivered energy conservation education with cognitive\u2013behavioral therapy seems to reduce fatigue impact and severity among people with post-TBI fatigue. Future appropriately powered RCTs could positively contribute to the evidence available to occupational therapy practitioners for this chronic, debilitating, and often overlooked symptom.\n                  <\/jats:p>","DOI":"10.5014\/ajot.2022.048587","type":"journal-article","created":{"date-parts":[[2022,6,24]],"date-time":"2022-06-24T11:22:06Z","timestamp":1656069726000},"page":"660-668","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["An Internet-Based Self-Management Intervention to Reduce Fatigue Among People With Traumatic Brain Injury: A Pilot Randomized Controlled Trial"],"prefix":"10.1177","volume":"76","author":[{"given":"Ketki D.","family":"Raina","sequence":"first","affiliation":[{"name":"Ketki D. 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