Fatigue in multiple sclerosis: association with disease-related, behavioural and psychosocial factors

Trojan, Daria A.; Arnold, Douglas L.; Collet, Jean Paul; Shapiro, Stan; Bar‐Or, Amit; Robinson, Ann; Cruguel, J-P Le; Ducruet, Thiérry; Narayanan, Sridar; Arcelin, Katia; Wong, Angelvene; Tartaglia, Maria Carmela; Lapierre, Yves; Caramanos, Zografos; Costa, Deborah Da

doi:10.1177/1352458507077175

Cited by 115 publications

(121 citation statements)

References 54 publications

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“…Fatigue, a multifactorial entity in MS with dimensions including energy loss, sleepiness, and inability to sustain activity, 34 seems to increase cognitive complaints 35 and is associated with reduced self-efficacy. 36 Although not expressly measured in this study, fatigue has been shown to be reducible with physical activity. 6 Further exploration of the relationship between somato-affective features of depression and aerobic exercise appears warranted.…”

Section: Resultsmentioning

confidence: 63%

Aerobic Exercise in People with Multiple Sclerosis

Swank¹,

Thompson²,

Medley³

2013

International Journal of MS Care

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The aims of this study were to explore the feasibility of structured aerobic exercise followed by a period of unstructured physical activity and determine the impact of such exercise on cognition, mood, and quality of life in people with multiple sclerosis (MS). A convenience sample of 9 individuals with relapsing-remitting MS performed 30 minutes of aerobic exercise (upper-and lower-extremity ergometry and treadmill ambulation) twice weekly for

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Section: Resultsmentioning

confidence: 63%

Aerobic Exercise in People with Multiple Sclerosis

Swank¹,

Thompson²,

Medley³

2013

International Journal of MS Care

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“…There is evidence for an association between morphological fitness, assessed as BMI, and symptomatic fatigue in MS. In a sample of 53 participants with moderate MS (mean EDSS=3.4), a higher BMI was associated with higher scores on the Multidimensional Fatigue Symptom Inventory physical fatigue subscale (r=0.36) [44]. Collectively, the existing research suggests physiological deconditioning in multiple domains might be related with more frequent and severe symptoms of fatigue in persons with MS.…”

Section: Fatiguementioning

confidence: 86%

The Importance of Physical Fitness in Multiple Sclerosis

Motl¹

2013

J Nov Physiother

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Multiple Sclerosis (MS) is a common and life-altering neurological disease among adults in the United States and worldwide. This disease has an estimated prevalence of 1 per 1,000 adults in the United States [1] with the majority of cases occurring in women of European descent. The MS pathophysiology initially involves episodic periods of immune-mediated demyelination and transection of axons within the Central Nervous System (CNS). This results in the disruption of saltatory conduction of action potentials along myelinated axonal pathways in the brain, spinal cord, and optic nerves. The MS pathophysiology later transitions into a neurodegenerative disease process, presumably associated with insufficient neurotrophic support, and results in the accumulation of irreversible neurologic disability. The degree and location of axonal and neuronal damage within the CNS result in the heterogeneous expression of symptomatic, functional, and participatory consequences among persons with MS [2]. Such manifestations might be initiated or worsened by physical inactivity and resulting physiological deconditioning.We have previously described a model of physical inactivity, deconditioning, and worsening MS [3,4], and this was based on a similar framework for persons with chronic disease conditions [5] including MS [6]. The model is displayed in figure 1 and indicates that MS onset results in physical inactivity [7,8] that initiates physiological deconditioning (i.e., compromised or reduced physical fitness). This physiological deconditioning, in turn, results in worsening of MS, as indicated by loss of brain structure and function as well as symptomatic (e.g., fatigue) and functional (e.g., walking impairment) manifestations. The worsening of MS results in further physical inactivity and subsequent physiological deconditioning thereby yields a cycle of associations among physical inactivity, deconditioning, and worsening MS that develops over time. This model is important as it conceptualizes the importance of maintaining and improving physical fitness levels in persons with MS. Physical fitness might provide a form of "physiological reserve" that is protective of disease consequences and worsening of MS and this is consistent with other literatures such as cancer [9].To that end, this paper provides a comprehensive review of research on physical fitness in persons with MS. We begin by defining physical fitness and its domains as well as differentiating it from physical activity. We then present research on physiological deconditioning (i.e., detraining that manifests as a reduction in domains of physical work capacity or fitness) in persons with MS as well as evidence on the association between markers of physical fitness and consequences of MS. We lastly review research regarding the effects of exercise training on physical fitness and consequences of MS, and conclude with recently developed exercise recommendations for improving physical fitness. Our goal is the provision of a paper that underscores the (a) importance of p...

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“…Sleep disturbances are the most disturbing. 51,52 In a recent expert review by Krupp et al, a multidisciplinary treatment approach is recommended, including cognitive-behavioural therapy, exercise therapy and substantial effort to reduce secondary fatigue-inducing factors. Based on the present review, exercise therapy seems to have an effect on MS fatigue and we suggest that exercise therapy should comprise a substantial part of the multidimensional approach.…”

Section: Effects Of Socializationmentioning

confidence: 99%

The effect of exercise therapy on fatigue in multiple sclerosis

2011

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Background: Fatigue occurs in the majority of patients with multiple sclerosis (MS) and therapeutic possibilities are few. Exercise therapy is a therapeutic option but no studies have systematically reviewed the existing literature evaluating the effect of exercise therapy on MS fatigue. Objective: To determine the effect of exercise therapy on MS fatigue by systematically reviewing the literature. Methods: A comprehensive literature search (PubMed, SweMed þ, Embase, Cochrane, CINAHL, PEDro, Sport Discuss and Bibliotek.dk) was conducted. Results: Studies evaluating the effect of exercise therapy on MS fatigue show heterogeneous results and only few studies have evaluated MS fatigue as the primary outcome. The heterogeneous findings seem to be related to the selected study population, which in many studies are non-fatigued. Most studies that have included fatigued patients with MS show positive effects, although it is not clear whether any exercise modalities are superior to others because there are no comparative studies regarding different exercise interventions. Conclusion: Exercise therapy has the potential to induce a positive effect on MS fatigue, but findings are heterogeneous probably because many studies have applied non-fatigued study populations. Furthermore, only few studies have evaluated MS fatigue as the primary outcome measure, emphasizing the need for future studies within this field.

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Fatigue in multiple sclerosis: association with disease-related, behavioural and psychosocial factors

Cited by 115 publications

References 54 publications

Aerobic Exercise in People with Multiple Sclerosis

Aerobic Exercise in People with Multiple Sclerosis

The Importance of Physical Fitness in Multiple Sclerosis

The effect of exercise therapy on fatigue in multiple sclerosis

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