Abstract
BackgroundSeveral rehabilitation programmes aim at reducing the impact of fatigue in MS patients. Acute and chronic fatigue should require different management.ObjectivesTo assess the effects of individually tailored, multidisciplinary outpatient rehabilitation (MDR) on chronic fatigue.MethodsForty-eight ambulatory MS patients with chronic fatigue were randomized to MDR or to MS–nurse consultation. Fatigue was assessed by the Checklist Individual Strength (CIS-20R). Secondary outcomes included the Modified Fatigue Impact Scale, Fatigue Severity Scale, Functional Independence Measure, Disability and Impact Profile (DIP), Multiple Sclerosis Impact Scale and the Impact on Participation and Autonomy (IPA).ResultsThe primary outcome measure CIS-20R overall score showed no significant differences between groups at 12 weeks (P = 0.39) and 24 weeks follow-up (P = 0.14), nor for subscales (t = 12 and t = 24, 0.19≤P≤0.88). No significant within-group effects were found for both groups with respect to the primary (0.57≤p≤0.97) and secondary (0.11≤p≤0.92) outcome measures from baseline to 12 or 24 weeks.ConclusionMultidisciplinary rehabilitation was not more effective in terms of reducing self-reported fatigue in MS patients compared to MS-nurse consultation. Our results suggest that chronic fatigue in patients with MS may be highly invariant over time, irrespective of interventions.Trial Registrationcontrolled-trials.com ISRCTN05017507
Highlights
Fatigue is a common and disabling symptom in people with multiple sclerosis (MS), and is considered to be one of the main causes of impaired daily activities and reduced quality of life [1]
Multidisciplinary rehabilitation was not more effective in terms of reducing self-reported fatigue in MS patients compared to MS-nurse consultation
Our results suggest that chronic fatigue in patients with MS may be highly invariant over time, irrespective of interventions
Summary
Fatigue is a common and disabling symptom in people with multiple sclerosis (MS), and is considered to be one of the main causes of impaired daily activities and reduced quality of life [1]. Chronic persistent fatigue is defined as ‘‘being present for any amount of time on 50 percent of the days, for more than 6 weeks’’, whereas acute fatigue is defined as ‘‘new or significant increase in feelings of fatigue in the previous six weeks’’. Both chronic and acute fatigue limit functional activities and quality of life, but may require different management strategies [6].
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