Abstract
BackgroundPhysical activity interventions have yielded reductions in fatigue and depressive symptoms among persons with multiple sclerosis(MS) who have not been screened for elevated baseline symptoms scores. PurposeThis short communication describes a secondary analysis of data from a previous randomized controlled trial (RCT) and focused on physical activity intervention effects on fatigue and depression among persons with MS who had elevated baseline symptom scores. MethodOf the 76 persons who completed the RCT, 64(84%) had baseline fatigue severity scale(FSS) scores indicating elevated levels of fatigue(n = 30,intervention; n = 34,control), and 26(34%) had baseline hospital anxiety and depression scale, depression(HADS-D) scores indicating elevated depressive symptoms (n = 13,intervention; n = 13,control). The physical activity intervention was delivered over a 6-month period, and the control condition was a 6-month waitlist. The participants completed the FSS and HADS-D as part of baseline and follow-up battery of assessments. ResultsThere was a statistically significant change in FSS scores favoring the physical activity intervention, and the effect size of 0.73 was larger than reported in a previous meta-analysis of RCTs of physical activity and fatigue in MS of 0.45(95%CI=.22,.68). We observed a statistically significant change in HADS-D scores favoring the physical activity intervention, and the effect size of 1.21 was larger than reported in a previous meta-analysis of RCTs of physical activity and depression in MS of 0.36(95%CI=.18,.54). ConclusionSuch results provide preliminarily support for the application of physical activity interventions for the “treatment” of fatigue and/or depression in MS, pending subsequent confirmatory efficacy or effectiveness trials.
Highlights
There is consistent evidence from meta-analyses of randomized controlled trials(RCTs) that physical activity interventions have yielded reductions in fatigue and depression among persons with multiple sclerosis(MS) [1,2]
The participants in that study were prescreened, in part, based on physical activity levels, but not fatigue or depressive symptoms. This short communication describes a secondary analysis of data from the single, aforementioned RCT [4] and examined the possibility that the effect of the physical activity intervention on fatigue and depression would be larger among participants purposefully selected based on elevated baseline symptom scores; this is necessary for testing the hypothesis that participants in that previous RCT who had elevated baseline levels of fatigue and depression would report larger effects of the physical activity intervention on those respective symptoms than documented in previous meta-analyses [1,2] or the original report from the aforementioned RCT [4]
This paper involved a secondary analysis of data from a single, previously published RCT [4] and examined the possibility that the effect of the physical activity intervention on fatigue and depression was larger among those with elevated baseline symptom scores
Summary
There is consistent evidence from meta-analyses of randomized controlled trials(RCTs) that physical activity interventions have yielded reductions in fatigue and depression among persons with multiple sclerosis(MS) [1,2]. Purpose: This short communication describes a secondary analysis of data from a previous randomized controlled trial (RCT) and focused on physical activity intervention effects on fatigue and depression among persons with MS who had elevated baseline symptom scores. Results: There was a statistically significant change in FSS scores favoring the physical activity intervention, and the effect size of 0.73 was larger than reported in a previous meta-analysis of RCTs of physical activity and fatigue in MS of 0.45(95%CI1⁄4.22,.68). We observed a statistically significant change in HADS-D scores favoring the physical activity intervention, and the effect size of 1.21 was larger than reported in a previous meta-analysis of RCTs of physical activity and depression in MS of 0.36(95%CI1⁄4.18,.54). Conclusion: Such results provide preliminarily support for the application of physical activity interventions for the “treatment” of fatigue and/or depression in MS, pending subsequent confirmatory efficacy or effectiveness trials
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