scholarly journals The effect of exercise therapy on fatigue in multiple sclerosis

2011 ◽  
Vol 17 (9) ◽  
pp. 1041-1054 ◽  
Author(s):  
AK Andreasen ◽  
E Stenager ◽  
U Dalgas
Keyword(s):  
Multiple Sclerosis ◽  
Exercise Therapy ◽  
Primary Outcome ◽  
Therapeutic Option ◽  
Primary Outcome Measure ◽  
Exercise Interventions ◽  
Future Studies ◽  
Positive Effects ◽  
Study Population ◽  
Positive Effect

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 +, 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.

scholarly journals Effect of Exercise Interventions on Anxiety in People with Multiple Sclerosis

2019 ◽  
Vol 22 (3) ◽  
pp. 103-109
Author(s):  
Claudia Gascoyne ◽  
Amalia Karahalios ◽  
Thibaut Demaneuf ◽  
Claudia Marck
Keyword(s):  
Multiple Sclerosis ◽  
Primary Outcome ◽  
Meta Analysis ◽  
A Priori ◽  
Primary Outcome Measure ◽  
Small Sample ◽  
Risk Of Bias ◽  
Exercise Interventions ◽  
Mean Differences ◽  
Small Sample Sizes

Abstract Background: Evidence suggests that exercise can alleviate symptoms associated with multiple sclerosis (MS). However, it is unclear whether exercise alleviates symptoms of anxiety, present in one-third of people with MS. This systematic review and meta-analysis investigates whether exercise interventions are effective in reducing anxiety in people with MS. Methods: CINAHL, Embase, MEDLINE, PsycINFO, and the Cochrane Controlled Clinical Trials Register were searched to identify relevant randomized controlled trials (RCTs) published up to March 30, 2018. The primary outcome was postintervention difference in anxiety scores between intervention and control groups. Using a restricted maximum likelihood random-effects model, standardized mean differences were pooled and heterogeneity was estimated. Risk of bias was assessed using an a priori modified Cochrane Risk of Bias 2.0 tool. Results: Four RCTs with 133 participants were included. Exercise type included walking, aerobic activities, and cycling. Intervention duration ranged from 8 to 26 weeks. The pooled standardized mean difference in anxiety score was −0.16 (95% CI, −0.50 to 0.19), without heterogeneity. Two studies had high risk of bias, and two had some risk of bias. Conclusions: Based on available RCT data, exercise does not seem to have an effect on anxiety in people with MS. These results should be interpreted with caution because studies had concerns of bias and small sample sizes, and anxiety was not the primary outcome measure. Future studies should exhibit sufficient reporting standards, alongside publishing protocols. There is opportunity to investigate the effect of exercise in people with MS experiencing clinically relevant levels of anxiety rather than in the general MS population.

A phase III trial of intramuscular recombinant interferon beta as treatment for exacerbating-remitting multiple sclerosis: design and conduct of study and baseline characteristics of patients

1995 ◽  
Vol 1 (2) ◽  
pp. 118-135 ◽  
Author(s):  
LD Jacobs ◽  
DL Cookfair ◽  
RA Rudick ◽  
RM Herndon ◽  
J R Richert ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Interferon Beta ◽  
Outcome Measure ◽  
Primary Outcome Measure ◽  
Phase Iii ◽  
Secondary Outcome ◽  
Recombinant Interferon ◽  
Study Population ◽  
The Mean ◽  
Baseline Characteristics

The design and conduct of a randomized, double-blinded, placebo-controlled, multicenter, phase III study of recombinant interferon beta-1a (IFN-β-1a) as treatment for exacerbating-remitting MS are described, as are baseline characteristics of the study population. The purpose of the study was to determine if 6.0 × 106 IU (30 μg) of IFN-β-1a, administered by weekly intramuscular (i.m.) injections, was effective in delaying the onset of sustained disability. The primary outcome measure was time to onset of treatment failure, defined as a worsening on the Kurtzke Expanded Disability Status Scale (EDSS) of greater than or equal to 1.0 point compared with baseline, persisting for at least 6 months. An intent-to-treat design was used. The primary outcome measure was analyzed using the Mantel-Cox log-rank statistic and Kaplan-Meier survival curves. Secondary outcomes included quantitative measures of upper and lower extremity function, neuropsychological test performance, functional and quality of life assessments and several measures derived from annual brain MRI studies. Entry criteria included prestudy exacerbation rates of at least 0.67 per year and EDSS scores of 1.0–3.5. A total of 301 MS patients were randomly assigned to receive weekly i.m. injections of IFN-β-1a or placebo. The average age of the study population at entry was 37 years; 92% were Caucasian and 73% were women. The mean prestudy disease duration was 6.5 years, mean prestudy exacerbation rate was 1.2 per year and the mean EDSS score was 2.3. The randomization yielded well-balanced treatment arms. Various aspects of the study are discussed, including: (1) the decision to focus study design on sustained disability; (2) the rationale for the treatment regimen; (3) measures taken to assure the reliability of the primary outcome measure; and (4) a description of the secondary outcome measures.

The Multiple Sclerosis Knowledge Questionnaire: a self-administered instrument for recently diagnosed patients

2009 ◽  
Vol 16 (1) ◽  
pp. 100-111 ◽  
Author(s):  
A. Giordano ◽  
M. Messmer Uccelli ◽  
E. Pucci ◽  
V. Martinelli ◽  
C. Borreani ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Internal Consistency ◽  
Primary Outcome ◽  
Positive Association ◽  
Primary Outcome Measure ◽  
Validation Sample ◽  
Newly Diagnosed ◽  
Knowledge Questionnaire ◽  
Sex Positive ◽  
Trial Participants

There are few studies on patient knowledge in multiple sclerosis (MS), and only two published questionnaires. The objective of this article was to develop and validate the MS Knowledge Questionnaire (MSKQ), a self-assessed instrument for newly diagnosed MS patients. Thirty multiple-choice statements, conceived to test MS knowledge, were produced by a multidisciplinary panel and pre-tested on three MS patients, resulting in an intermediate 26-item version. This was tested on 54 MS patients for internal consistency, content and construct validity (validation sample I). The final (25-item) MSKQ was a primary outcome measure in the SIMS-Trial on an information aid to newly diagnosed MS patients. Postal responses of SIMS-Trial participants to the MSKQ a month after intervention (validation sample II) were analysed. Median MSKQ scores in validation samples I and II were, respectively, 18 (range 9—23) and 17 (range 3—24). Acceptability, internal consistency (Kuder—Richardson-20 formula 0.76) and content validity were good. Educational attainment and receiving the information aid were the main independent predictors of MS knowledge. Other predictors were female sex (positive association) and disease duration (negative association). In conclusion, the MSKQ has good clinimetric properties and is sensitive to an educational intervention. We propose the MSKQ as a brief instrument for clinical practice and research.

scholarly journals Diverse mechanisms and treatment strategies to confront fatigue in multiple sclerosis: A systematic review

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 563
Author(s):  
Sumanth Khadke ◽  
tehmina siddique
Keyword(s):  
Multiple Sclerosis ◽  
Systematic Reviews ◽  
Observational Studies ◽  
Behavioral Therapy ◽  
Combined Treatment ◽  
Cochrane Review ◽  
Treatment Strategies ◽  
Individual Treatment ◽  
Positive Effects ◽  
Positive Effect

Background: Firm conclusions about the applicability of treatment methods other than pharmacotherapy in treating fatigue in multiple sclerosis (MS) remain elusive. Our objective is to synthesize and review the epidemiological literature systematically and find an effective therapeutic plan for fatigue. The effect of individual treatment and combined treatment strategies are studied. Methods: An electronic database search included EBSCO, PubMed, SCIENCE DIRECT and Scopus from January 1, 2013, to September 30, 2018. Search terms used are “Fatigue AND Multiple sclerosis AND therapy”. The articles included in the study are open access, published in last five years, not restricted to region and language. The search included randomized controlled trials (RCTs), observational studies, and systematic reviews. Results: We included 13 systematic reviews, 10 RCTs and 7 observational studies. A Cochrane review on 3206 patients showed exercise therapy to have a positive effect on fatigue in RRMS patients. The EPOC trial showed switching interferon therapy or glatiramer to fingolimod showed improved fatigue levels. The FACETS trial showed incorporating behavioral therapy to ongoing recommended therapy is beneficial. Few observational studies demonstrated that fatigue is influenced by pain, mood problems, and depression. Conclusions: The diverse pathology of fatigue related to MS is important in understanding and quantifying the role of each causal factor. Evidence reveals a positive effect on fatigue levels of RRMS patients with regular CBT and exercise-based combination therapy. Progressive forms of the disease have the worst prognosis. Individually aerobic exercises, behavioral therapy and pharmacotherapy have positive effects. A modified amalgamation of the same is a better hope for MS patients.

scholarly journals Clinical trials in REM sleep behavioural disorder: challenges and opportunities

2020 ◽  
Vol 91 (7) ◽  
pp. 740-749 ◽  
Author(s):  
Aleksandar Videnovic ◽  
Yo-El S Ju ◽  
Isabelle Arnulf ◽  
Valérie Cochen-De Cock ◽  
Birgit Högl ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Primary Outcome ◽  
Cost Effective ◽  
Symptomatic Treatment ◽  
Primary Outcome Measure ◽  
Behavioural Disorder ◽  
Medical Community ◽  
Ambulatory Setting ◽  
Study Population ◽  
Disease Modifying

The rapid eye movement sleep behavioural disorder (RBD) population is an ideal study population for testing disease-modifying treatments for synucleinopathies, since RBD represents an early prodromal stage of synucleinopathy when neuropathology may be more responsive to treatment. While clonazepam and melatonin are most commonly used as symptomatic treatments for RBD, clinical trials of symptomatic treatments are also needed to identify evidence-based treatments. A comprehensive framework for both disease-modifying and symptomatic treatment trials in RBD is described, including potential treatments in the pipeline, cost-effective participant recruitment and selection, study design, outcomes and dissemination of results. For disease-modifying treatment clinical trials, the recommended primary outcome is phenoconversion to an overt synucleinopathy, and stratification features should be used to select a study population at high risk of phenoconversion, to enable more rapid clinical trials. For symptomatic treatment clinical trials, objective polysomnogram-based measurement of RBD-related movements and vocalisations should be the primary outcome measure, rather than subjective scales or diaries. Mobile technology to enable objective measurement of RBD episodes in the ambulatory setting, and advances in imaging, biofluid, tissue, and neurophysiological biomarkers of synucleinopathies, will enable more efficient clinical trials but are still in development. Increasing awareness of RBD among the general public and medical community coupled with timely diagnosis of these diseases will facilitate progress in the development of therapeutics for RBD and associated neurodegenerative disorders.

Do cannabis-based medicinal extracts have general or specific effects on symptoms in multiple sclerosis? A double-blind, randomized, placebo-controlled study on 160 patients

2004 ◽  
Vol 10 (4) ◽  
pp. 434-441 ◽  
Author(s):  
Derick T Wade ◽  
Petra Makela ◽  
Philip Robson ◽  
Heather House ◽  
Cynthia Bateman
Keyword(s):  
Multiple Sclerosis ◽  
Primary Outcome ◽  
Primary Outcome Measure ◽  
Controlled Study ◽  
Double Blind ◽  
Specific Effects ◽  
Whole Plant ◽  
Parallel Group ◽  
Troublesome Symptom ◽  
Vas Scores

The objective was to determine whether a cannabis-based medicinal extract (CBME) benefits a range of symptoms due to multiple sclerosis (MS). A parallel group, double-blind, randomized, placebo-controlled study was undertaken in three centres, recruiting 160 outpatients with MS experiencing significant problems from at least one of the following: spasticity, spasms, bladder problems, tremor or pain. The interventions were oromucosal sprays of matched placebo, or whole plant CBME containing equal amounts of delta-9- tetrahydrocannabinol (THC) and cannabidiol (CBD) at a dose of 2.5- 120 mg of each daily, in divided doses. The primary outcome measure was a Visual Analogue Scale (VAS) score for each patient’s most troublesome symptom. Additional measures included VAS scores of other symptoms, and measures of disability, cognition, mood, sleep and fatigue. Following CBME the primary symptom score reduced from mean (SE) 74.36 (11.1) to 48.89 (22.0) following CBME and from 74.31 (12.5) to 54.79 (26.3) following placebo [ns]. Spasticity VAS scores were significantly reduced by CBME (Sativex) in comparison with placebo (P- 0.001). There were no significant adverse effects on cognition or mood and intoxication was generally mild.

Reflexology for the treatment of pain in people with multiple sclerosis: a double-blind randomised sham-controlled clinical trial

2009 ◽  
Vol 15 (11) ◽  
pp. 1329-1338 ◽  
Author(s):  
CM Hughes ◽  
S. Smyth ◽  
AS Lowe-Strong
Keyword(s):  
Multiple Sclerosis ◽  
Primary Outcome Measure ◽  
Controlled Clinical Trial ◽  
Double Blind ◽  
Positive Effects ◽  
Vas Scores ◽  
Clinically Significant ◽  
Randomised Controlled

Multiple sclerosis (MS) results in pain and other symptoms which may be modified by conventional treatment, however, MS is still not curable. Several studies have reported positive effects of reflexology in the treatment of pain, however, no randomised controlled clinical trials for the treatment of pain have been conducted within this population. The objective of this study was to investigate the effectiveness of reflexology on pain in and MS population. We randomly allocated 73 participants to receive either precision or sham reflexology weekly for 10 weeks. Outcome measures were taken pre-and post-treatment with follow-up at 6 and 12 weeks by a researcher blinded to group allocation. The primary outcome measure recorded pain using a Visual Analogue Scale (VAS). A significant (p < 0.0001) and clinically important decrease in pain intensity was observed in both groups compared with baseline. Median VAS scores were reduced by 50% following treatment, and maintained for up to 12 weeks. Significant decreases were also observed for fatigue, depression, disability, spasm and quality of life. In conclusion, precision reflexology was not superior to sham, however, both treatments offer clinically significant improvements for MS symptoms via a possible placebo effect or stimulation of reflex points in the feet using non-specific massage.

Survey of relationship between attitude and practice toward prayer and depression in student of kurdistan university of medical sciences of Iran, in 2009

2011 ◽  
Vol 26 (S2) ◽  
pp. 678-678 ◽  
Author(s):  
F. Ranaie ◽  
F. Zaheri ◽  
F. Ardalan
Keyword(s):  
Random Sampling ◽  
Positive Attitude ◽  
Sampling Method ◽  
Good Practice ◽  
Medical Sciences ◽  
Positive Effects ◽  
Attitude And Practice ◽  
Study Population ◽  
Severity Of Depression ◽  
Positive Effect

Background and aimsMental disorders are of diseases that modern societies encounter with and among them depression is one of the most common disorder especially in young people as prayer and blessing has positive effects on different aspects of life, this study was done to determine relationship between attitude and practice toward prayer and depression in students of Kurdistan university of medical sciences.Subject and methodsThis was a descriptive - analytic study. The study population consisted of 400 students of Kurdistan university of medical sciences that were selected though stratified random sampling method. The data were collected by 2 questionnaires, one that contained questions related to attitude and practice toward prayer and another was beck test.Results37.5% has depression (mild to severe). 71% had positive attitude and 29.5% had good practice toward prayer. There was significant relations ship between attitude toward prayer and depression (p = 0/03). So that depression average ranking was lower in those who had positive attitude toward prayer.With higher mean scores of practice toward prayer depression rates were lower but these. Differences were not significant.ConclusionAs depression rate is high in these students and because of positive effect of prayer on decreasing prevalence and severity of depression so not only exploring for risk factors of depression in university students is necessary but also reinforcing and promoting doing prayer and religious duties: it is recommended to pay more attention to student's mental health.

Does a Systematic Vocal Exercise Program Enhance the Physiologic Range of Voice Production in Classical Singing Graduate-Level Students?

2020 ◽  
Vol 63 (4) ◽  
pp. 1044-1052 ◽  
Author(s):  
Marco Guzman ◽  
Vrushali Angadi ◽  
Daniel Croake ◽  
Christopher Catalan ◽  
Constanza Romero ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Outcome Measure ◽  
Exercise Program ◽  
Primary Outcome Measure ◽  
Graduate Level ◽  
Vocal Hygiene ◽  
Positive Effects ◽  
Vocal Training ◽  
Classical Singing ◽  
Voice Range

Purpose The purpose of this study was to assess the effects of vocal function exercises (VFEs) on the physiologic range of the operatic voice. The primary outcome measure was total voice range profile (VRP) area. Method Forty graduate-level opera majors were randomly assigned to experimental (training with VFE + vocal hygiene) and control (vocal hygiene only) groups. All participants underwent an acoustic voice assessment (modified VRP) pre and post 10 weeks of the assigned intervention. VRP total area was calculated and compared between and within the two groups. The total VRP area was subsequently divided into three area thirds (low, medium, and high). Results A significant improvement (increase) was observed in the VFE group for the primary outcome measure of VRP area when pre- and postvoice conditions were compared for total area, upper third, and middle third. No significant improvement was found in the vocal hygiene–only group. Conclusion Vocal training with VFEs over a 10-week period demonstrated positive effects on physiologic voice range as evidenced by an increase in the total VRP area and therefore may enhance the potential of those who already have professional voice training.

Change in quality of life in patients with relapsing–remitting multiple sclerosis over 2 years in relation to other clinical parameters: results from a trial of intramuscular interferon β-1a

2011 ◽  
Vol 17 (6) ◽  
pp. 734-742 ◽  
Author(s):  
DM Miller ◽  
B Weinstock-Guttman ◽  
D Bourdette ◽  
X You ◽  
P Foulds ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Primary Outcome ◽  
Outcome Measure ◽  
Primary Outcome Measure ◽  
Disability Progression ◽  
Relapsing Remitting ◽  
Remitting Multiple Sclerosis ◽  
Relapsing Remitting Multiple Sclerosis

Background: A randomized, placebo-controlled, multicenter study of weekly intramuscular injections of interferon beta-1a (IFNβ-1a) in relapsing–remitting multiple sclerosis included the Sickness Impact Profile (SIP), a validated measure of patient-reported quality of life (QoL). Objective: To demonstrate the impact of moderate to severe SIP disability at baseline and change in QoL as measured by SIP over 2 years in relation to other study parameters. Methods: In 158 patients, SIP scores were determined at baseline and 2 years. Scores were correlated with disease progression and treatment. Results: Patients who experienced disability progression, as defined by Expanded Disability Status Scale (EDSS) and annualized relapse rate, during the study demonstrated significant worsening in Physical SIP scores compared with patients who did not progress ( p = 0.031). In patients with low SIP scores, indicating moderate or severe disability at baseline, treatment with IFNβ-1a significantly improved Physical SIP subscores. Conclusions: Patients with disability progression defined using EDSS, the physician-derived primary outcome measure, had Physical SIP scores indicating worsening disability, validating the physician-derived primary outcome measure using patient self-report. Treatment with IFNβ-1a had beneficial effects on QoL in patients with worse SIP scores at baseline.

Sign in / Sign up

Export Citation Format

Share Document