How does exercise influence fatigue in people with multiple sclerosis?

Smith, Christopher; Hale, Leigh; Olson, Kärin; Schneiders, Anthony G.

doi:10.1080/09638280802273473

Cited by 56 publications

(137 citation statements)

References 20 publications

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“…We can suppose, as other studies suggested [33,34], that better perceived physical improvements in strength and balance due to individualized neuromotor strategies can reduce the fatigue experience.…”

Section: Discussionmentioning

confidence: 94%

Impact of fatigue on the efficacy of rehabilitation in multiple sclerosis

et al. 2011

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Fatigue is considered to be one of the most common and disabling symptoms among individuals with multiple sclerosis (MS). The aim of this study is to investigate if an intensive, short-term inpatient rehabilitation program is able to improve fatigue in MS, and if fatigue is able to negatively influence the clinical and functional outcome of rehabilitation in MS. One-hundred eighty six consecutively recruited MS patients underwent an intensive, short-term inpatient rehabilitation program. Sixty-four of them were selected for this study according to our inclusion criteria and compared to a control group of 22 MS patients who did not follow a rehabilitation program. We measured fatigue symptoms with the Fatigue Severity Scale (FSS) before and after rehabilitation, and classified patients into fatigued (FMS) in the case of an FSS score ≥36 and into non-fatigued MS (NFMS) in the case of an FSS <36. Expanded Disability Status Scale (EDSS) and Functional Independence Measure (FIM) were used as clinical outcome measures of the efficacy of the rehabilitation program. In our sample, an intensive, short-term rehabilitation treatment is able to determine a significant reduction of fatigue symptoms compared to untreated MS patients (p < 0.0001); however, the presence of fatigue at the beginning of the rehab program seems not to have any impact on the clinical and functional outcome of rehabilitation. An intensive inpatient rehabilitation trial decreases symptom of fatigue in MS patients; furthermore fatigue seems not to modify the amelioration of disability and impairment determined by a rehabilitation program.

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Section: Discussionmentioning

confidence: 94%

Impact of fatigue on the efficacy of rehabilitation in multiple sclerosis

et al. 2011

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“…Regular physical activity has been recognized as one of the most consistent positive interventions in patients with MS [10], resulting in improved cardiovascular function, muscular strength and the delayed onset of fatigue [11]. Ironically, acute exercise itself has been suggested to lead to a worsening of symptoms, reduced activity [12], and chronic inflammation [13].…”

Section: Introductionmentioning

confidence: 99%

Vascular function and multiple sclerosis

et al. 2011

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Multiple sclerosis (MS) is a debilitating disease with an assumed autoimmune etiology which may lead to elevated oxidative stress, vascular dysfunction, and subsequent predisposition to cardiovascular disease. Therefore, the primary aim of this study was to evaluate vascular function and the potential role of oxidative stress in patients diagnosed with MS compared to healthy controls (C). Fourteen patients with relapsing-remitting MS (47 ± 3 years) and 13 age- and activity-matched controls (44 ± 5 years) underwent brachial artery flow-mediated dilation (FMD) and reactive hyperemia testing using ultrasound Doppler. Venous blood was analyzed for C-reactive protein (CRP), lipid hydroperoxides (LH), the ferric reducing ability of plasma (FRAP), superoxide dismutase (SOD), and catalase activity. CRP [1.8 ± 0.5 mg/L (MS), 1.0 ± 0.5 mg/L (C)] and LH [1.2 ± 0.2 μmol/L (MS), 1.1 ± 0.1 μmol/L (C)] were not different between MS patients and controls. FMD [8.0 ± 1.2% (MS) and 9.2 ± 1.6% (C)] and reactive hyperemia [380 ± 61 mL (MS) and 402 ± 69 mL (C)] were also not different between groups. Vascular function, as assessed by both FMD and reactive hyperemia, was not impaired in patients with MS compared to controls. Further, there was no evidence of elevated systemic inflammation or oxidative stress in these patients, who were currently all in remission. These findings suggest that impaired vascular function, elevated inflammation and oxidative stress are not an obligatory accompaniment to MS.

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“…13 However, past evidence is unclear as to whether exercise may increase symptoms (ie, pain or fatigue) immediately following exercise in those with MS and CFS. 2,[9][10][11] Indeed, concern about a detrimental effect of exercise may deter people with these diseases from undertaking exercise, despite the absence of strong quantitative evidence that exercise may negatively affect symptoms over a longer period of time. In this study investigating the immediate effect of exercise on people with MS and CFS, we hypothesized that undertaking a 15-minute bout of aerobic exercise would increase pain and fatigue and decrease function for up to 24 hours following exercise.…”

Section: Participantsmentioning

confidence: 99%

“…In contrast, Mostert and Kesselring 8 reported an immediate negative effect following cycling in people with MS, with increased muscle spasms. Qualitative evidence in studies of MS suggests that fatigue [9][10][11] and muscle pain 9 may result the day after exercise.…”

Section: Participantsmentioning

confidence: 99%