Does aerobic training alleviate fatigue and improve societal participation in patients with multiple sclerosis? A randomized controlled trial.

Autor:	Heine M; VUmc MS Center Amsterdam and Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands/Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and Rehabilitation Center De Hoogstraat, Utrecht, The Netherlands., Verschuren O; Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and Rehabilitation Center De Hoogstraat, Utrecht, The Netherlands., Hoogervorst EL; Multiple Sclerosis Center, St Antonius Hospital, Nieuwegein, The Netherlands., van Munster E; Department of Neurology, Jeroen Bosch Ziekenhuis, Den Bosch, The Netherlands., Hacking HG; Multiple Sclerosis Center, St Antonius Hospital, Nieuwegein, The Netherlands., Visser-Meily A; Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and Rehabilitation Center De Hoogstraat, Utrecht, The Netherlands., Twisk JW; Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands/EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands., Beckerman H; VUmc MS Center Amsterdam and Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands; EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands., de Groot V; VUmc MS Center Amsterdam and Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands; EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands., Kwakkel G; VUmc MS Center Amsterdam and Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands/Department of Neurorehabilitation, Reade Center of Rehabilitation and Rheumatology, Amsterdam, The Netherlands/Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA.
Jazyk:	angličtina
Zdroj:	Multiple sclerosis (Houndmills, Basingstoke, England) [Mult Scler] 2017 Oct; Vol. 23 (11), pp. 1517-1526. Date of Electronic Publication: 2017 May 22.
DOI:	10.1177/1352458517696596
Abstrakt:	Background: Evidence supporting the effectiveness of aerobic training, specific for fatigue, in severely fatigued patients with multiple sclerosis (MS) is lacking. Objective: To estimate the effectiveness of aerobic training on MS-related fatigue and societal participation in ambulant patients with severe MS-related fatigue. Methods: Patients ( N = 90) with severe MS-related fatigue were allocated to 16-week aerobic training or control intervention. Primary outcomes were perceived fatigue (Checklist Individual Strength (CIS20r) fatigue subscale) and societal participation. An improvement of ⩾8 points on the CIS20r fatigue subscale was considered clinically relevant. Outcomes were assessed by a blinded observer at baseline, 2, 4, 6 and 12 months. Results: Of the 89 patients that started treatment (median Expanded Disability Status Scale (interquartile range), 3.0 (2.0-3.6); mean CIS20r fatigue subscale (standard deviation (SD)), 42.6 (8.0)), 43 received aerobic training and 46 received the control intervention. A significant post-intervention between-group mean difference (MD) on the CIS20r fatigue subscale of 4.708 (95% confidence interval (CI) = 1.003-8.412; p  = 0.014) points was found in favour of aerobic training that, however, was not sustained during follow-up. No effect was found on societal participation. Conclusion: Aerobic training in MS patients with severe fatigue does not lead to a clinically meaningful reduction in fatigue or societal participation when compared to a low-intensity control intervention.
Databáze:	MEDLINE
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