A scoping review of rehabilitation interventions that reduce fatigue among adults with multiple sclerosis

Asano, Miho; Berg, Elizabeth; Johnson, Katherine; Turpin, Merrill; Finlayson, Marcia

doi:10.3109/09638288.2014.944996

Cited by 43 publications

(20 citation statements)

References 61 publications

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“…Unfortunately, the multifactorial pathogenesis of fatigue in MS is not completely understood, and evidence-based treatment options remain scarce (Asano et al, 2014;Bol et al, 2009;Kos et al, 2008;Pucci et al, 2007). Bol et al (2010) examined its multifactorial pathogenesis by fitting a biomedical and a cognitive behavioral model in a sample of 262 patients with MS using structural equation modelling (SEM).…”

Section: Introductionmentioning

confidence: 99%

Explaining fatigue in multiple sclerosis: cross-validation of a biopsychosocial model

et al. 2016

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Fatigue is a common and disabling symptom in patients with multiple sclerosis (MS), but its pathogenesis is still poorly understood and consequently evidence-based treatment options are limited. Bol et al. (J Behav Med 33(5):355-363, 2010) suggested a new model, which explains fatigue in MS from a biopsychosocial perspective, including cognitive-behavioral factors. For purposes of generalization to clinical practice, cross-validation of this model in another sample of 218 patients with MS was performed using structural equation modeling. Path analysis indicated a close and adequate global fit (RMSEA = 0.053 and CFI = 0.992). The cross-validated model indicates a significant role for disease severity, depression and a fear-avoidance cycle in explaining MS-related fatigue. Modifiable factors, such as depression and catastrophizing thoughts, propose targets for treatment options. Our findings are in line with recent evidence for the effectiveness of a new generation of cognitive behavioral therapy, including acceptance and mindfulness-based interventions, and provide a theoretical framework for treating fatigue in MS.

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Section: Introductionmentioning

confidence: 99%

Explaining fatigue in multiple sclerosis: cross-validation of a biopsychosocial model

et al. 2016

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“…Systematic reviews and metaanalyses of exercise training in people with MS with mild-to-moderate disability support a consistent, moderate effect on symptoms of fatigue. 25,35,36 The 4-week trial of FES cycling in nonambulatory participants similarly reported a moderate decrease (d = -0.55) in symptoms of pain based on the Medical Outcomes Study Pain Effects Scale; however, there was no change in quality of life (MS Quality of Life Inventory) observed after the trial. 34 There is limited evidence for the role of exercise…”

Section: Participantsmentioning

confidence: 99%

Functional Electrical Stimulation Cycling Exercise in People with Multiple Sclerosis

Pilutti¹,

Edwards²,

Motl³

et al. 2019

International Journal of MS Care

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Background: Functional electrical stimulation (FES) cycling is an advanced rehabilitation modality that involves systematic mild electrical stimulation of focal muscle groups to produce leg cycling movement against an adjustable work rate. The present study reports on the efficacy of an assessor-blinded, pilot randomized controlled trial of supervised FES cycling exercise in people with multiple sclerosis (MS) on secondary trial outcomes, including cognition, fatigue, pain, and health-related quality of life. Methods: Eleven adult participants with MS were randomized to receive FES cycling exercise (n = 6) or passive leg cycling (n = 5) for 24 weeks. Cognitive processing speed was assessed using the Symbol Digit Modalities Test. Symptoms of fatigue and pain were assessed using the Fatigue Severity Scale, the Modified Fatigue Impact Scale, and the short-form McGill Pain Questionnaire. Physical and psychological health-related quality of life were assessed using the 29-item Multiple Sclerosis Impact Scale. Results: Eight participants (four, FES; four, passive leg cycling) completed the intervention and outcome assessments. The FES cycling exercise resulted in moderate-to-large improvements in cognitive processing speed (d = 0.53), fatigue severity (d = −0.92), fatigue impact (d = −0.45 to −0.68), and pain symptoms (d = −0.67). The effect of the intervention on cognitive performance resulted in a clinically meaningful change, based on established criteria. Conclusions: We provide preliminary evidence for the benefits of FES cycling exercise on cognition and symptoms of fatigue and pain. Appropriately powered randomized controlled trials of FES cycling exercise are necessary to determine its efficacy for people with MS.

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“…In particular, the primary goal of clinicians in hospitals and MS rehabilitation centres is to improve the above mentioned neurological deficits, by reducing the limitations of activity and participation, to reach the highest possible level of independence, in order to maintain or even improve the quality of life of pwMS [14]. Given the heterogeneous symptoms of pwMS, a multidisciplinary approach is often warranted, including physiotherapy, occupational therapy, psychological and coping programs, cognitive rehabilitation, speech therapy and therapy to improve fatigue [15][16][17][18][19][20][21][22][23][24][25].…”

Section: Introductionmentioning

confidence: 99%

Muscular, cardiac, ventilatory and metabolic dysfunction in patients with multiple sclerosis: Implications for screening, clinical care and endurance and resistance exercise therapy, a scoping review

Wens

Eijnde

Hansen

2016

Journal of the Neurological Sciences

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In the treatment of multiple sclerosis (MS), exercise training is now considered a cornerstone. However, most clinicians tend to focus on neurologic deficits only, and thus prefer to prescribe rehabilitation programs specifically to counteract these deficits. However, the present comprehensive review shows that patients with MS (pwMS) also experience significant muscular, cardiac, ventilatory and metabolic dysfunction, which significantly contribute, next to neurologic deficits, to exercise intolerance. In addition, these anomalies also might increase the risk for frequent hospitalization and morbidity and can reduce life expectancy. Unfortunately, the impact of exercise intervention on these anomalies in pwMS are mostly unknown. Therefore, it is suggested that pwMS should be screened systematically for muscular, cardiac, ventilatory and metabolic function during exercise testing. The detection of such anomalies should lead to adaptations and optimisation of exercise training prescription and clinical care/medical treatment of pwMS. In addition, future studies should focus on the impact of exercise intervention on muscular, cardiac, ventilatory and metabolic (dys)function in pwMS, to contribute to improved treatment and care.

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A scoping review of rehabilitation interventions that reduce fatigue among adults with multiple sclerosis

Cited by 43 publications

References 61 publications

Explaining fatigue in multiple sclerosis: cross-validation of a biopsychosocial model

Explaining fatigue in multiple sclerosis: cross-validation of a biopsychosocial model

Functional Electrical Stimulation Cycling Exercise in People with Multiple Sclerosis

Muscular, cardiac, ventilatory and metabolic dysfunction in patients with multiple sclerosis: Implications for screening, clinical care and endurance and resistance exercise therapy, a scoping review

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