Benefits of Individualized Training in Fatigued Patients with Multiple Sclerosis.

Abstract

Chronic fatigue is the most common and debilitating symptom in people with multiple sclerosis (PwMS). Recently, exercise has been proven to alleviate chronic fatigue and improve physical functions. Tailoring the training intervention to the potential fatigue causes could optimize the beneficial effects of training on fatigue. The objective of this study was to compare the effectiveness of an individualized (IND) vs a traditional (TRAD) exercise intervention in reducing chronic fatigue. Twenty-nine PwMS with high chronic fatigue were randomly assigned to 12 weeks of either a TRAD or IND exercise intervention. TRAD comprised aerobic and resistance exercises according to the guidelines for PwMS. IND specifically addressed identified individual weaknesses. Participants visited the laboratory before and after training for the following assessments: patient reported outcomes (fatigue, quality of life, depression questionnaires), incremental cycling test (V̇O2peak), and cycling fatigue test (maximal voluntary contraction, MVC; rating of perceived exertion, RPE). Similar improvements in fatigue, depression and quality of life were observed between groups (p > 0.05). Compared to TRAD, IND induced a significant greater increase in V̇O2peak (+21.0 ± 13.9 vs 6.8 ± 11.5%, p < 0.05) and a greater reduction in RPE at a given submaximal intensity (-30.3 ± 18.9 vs -12.1 ± 20.4%, p < 0.001), whereas MVC increased similarly in both groups (p > 0.05). Although tailored exercise improved similarly fatigue and other subjective parameters (depression, quality of life, sleep quality) compared to than traditional exercise interventions, prescribing an individualized intervention led to greater improvement in V̇O2peak (but not maximal strength) and perception of effort. This may have positive functional consequences for patients.