Evidence-based occupational and physical therapy for children and adolescents with inflammatory pediatric rheumatic diseases suffering from fatigue

Introduction: The aim of the evidence-based guideline is to identify measurement tools to assess fatigue and interventions to treat fatigue in children and adolescents with pediatric rheumatic diseases (PRD). The purpose is to systematize the care and improve the quality of occupational therapy and physiotherapy for this patient group. The guideline is developed according to The Appraisal of Guidelines for Research and Evaluation (AGREE) Instrument. Main section: In the guideline, 17 studies were included. Clinical expertise from both specialist and municipal health services as well as patient experiences and preferences were obtained. The guideline is based on a biopsychosocial understanding of fatigue. It is divided into two parts; assessment and intervention. The assessment part emphasizes how fatigue affects participation in everyday life, activity registration, and assessment of different factors that influence fatigue. The intervention part consists of patient education to raise awareness of fatigue, regulation of activity level, enhancing self-efficacy, treatment of factors contributing to fatigue and collaboration with other professionals involved in the care of the patient. Conclusion: Fatigue is complex. Scientific evidence is limited for assessment and interventions of fatigue in children and adolescents with PRD. The evidence-based guideline is mainly based on clinical experience and patient preferences.