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Review Article
 
The impact of the episodic nature of chronic illness: A comparison of fibromyalgia, multiple sclerosis and human immunodeficiency virus
Saipriya Vajravelu1, Kelly K O'Brien2, Sandra Moll3, Patricia Solomon4
1MSc, McMaster University – PhD Candidate, School of Rehabilitation Science, Hamilton, Ontario, Canada.
2PhD, University of Toronto – Assistant Professor, Department of Physical Therapy, Rehabilitation Sciences Institute (RSI), Institute of Health Policy, Management and Evaluation (IHPME), Toronto, Ontario, Canada.
3PhD, McMaster University – Assistant Professor, School of Rehabilitation Science, Hamilton, Ontario, Canada.
4PhD, McMaster University – Associate Dean, Director and Professor, School of Rehabilitation Science, Hamilton, Ontario, Canada.

Article ID: 100011D05SV2016
doi:10.5348/D05-2016-11-RA-7

Address correspondence to:
Saipriya Vajravelu
M.Sc., PhD Candidate, School of Rehabilitation Science, Institute of Applied Health Sciences
Room 308, McMaster University, 1400 Main Street West
Hamilton, Ontario
Canada, L8S 1C7

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How to cite this article
Vajravelu S, Kelly K O'Brien, Moll S, Solomon P. The impact of the episodic nature of chronic illness: A comparison of fibromyalgia, multiple sclerosis and human immunodeficiency virus. Edorium J Disabil Rehabil 2016;2:53–65.


Abstract
The purpose of this narrative review was to describe and compare the characteristics and episodic nature of disability among three chronic illnesses: multiple sclerosis (MS), HIV and fibromyalgia (FM). Searches were performed in electronic databases using a combination of keywords including episodic, relapse, remission, and fluctuation. We included articles published between 2004–2014 that described health challenges and the episodic nature of the illness. Data were extracted from selected articles, including the authors, date of publication, study population, the aims of the study, outcome measures and main study findings, and then were charted and collated to the dimensions of disability in the episodic disability framework. The descriptive words about symptoms/impairments, difficulty in day to day functioning, challenges to social inclusion and uncertainty were compared across illnesses to identify similarities and differences. We reported findings as a narrative summation. Forty-seven articles were included in this review. The comparison of the three chronic illnesses demonstrated that some of the symptoms/impairments such as pain, fatigue, sleep disturbance, depression, stress, and anxiety were reported commonly across illnesses. Similarly, difficulty with day to day functioning, challenges to social inclusion and uncertainty were reported across illnesses. On the other hand, factors influencing the symptoms, difficulties in daily functioning, challenges to social inclusion and uncertainty were found to be different. The episodic nature of the illness was identified among the three chronic conditions. People living with FM or MS or HIV, experience some common dimensions of disability that may be similarly experienced as episodic in nature. These similarities may not be exclusive to these three chronic illnesses, but could apply to individuals living with other chronic and episodic illnesses. Pursuing ways to enhance rehabilitation services among the conditions that experience similar episodic disability may help collectively to address disability and improve the overall health of people living with chronic illnesses.

Keywords: Chronic illness, Episodic disability, Fibromyalgia, Multiple Sclerosis, Rehabilitation


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Author Contributions:
Saipriya Vajravelu – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Kelly O'Brein – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Sandra Moll – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Patricia Solomon – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2016 Saipriya Vajravelu et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.