Aerobic exercise, cognitive behavioural therapy and energy conservation management for Multiple Sclerosis (MS) fatigue: Are three trials better than one?

TY - JOUR

T1 - Aerobic exercise, cognitive behavioural therapy and energy conservation management for Multiple Sclerosis (MS) fatigue: Are three trials better than one?

AU - Moss-Morris, Rona

AU - Norton, Sam

PY - 2017/10

Y1 - 2017/10

N2 - This edition of Multiple Sclerosis Journal includes reports from three randomised controlled trials (RCTs) of cognitive behaviour therapy1, aerobic training2 and energy conservation3 management for the treatment of MS fatigue. The three trials were led by separate research teams as part of the Dutch TREFAMS-ACE consortium4. Each trial compared one of the active treatments against a standardised control condition of three 45-minute individual face-to-face consultations with experienced and trained MS-nurses over a 4-month period. The MS nurses gave patients a standardised brochure about fatigue. Patients had the opportunity to discuss their fatigue and set goals for managing fatigue. In contrast, the three active treatments (summarised in the Table) included 12 45 minute individual face-to face treatment sessions with a health professional over the same time period. Participants in all three trials were followed up over 12-months. The primary outcomes, Checklist Individual Strengths (CIS20r)5 domain fatigue and Impact on Participation and Autonomy Questionnaire (IPA) 6 were identical in all studies. Secondary outcomes included the Modified Fatigue Impact Scale7 and the Fatigue Severity Scale8. ECM showed no significant improvements over the control condition on any outcomes. The CBT and aerobic training RCTS reported positive effects on the primary and secondary fatigue measures at the end of treatment, but effects were lost at 52-weeks follow-up. None of the trials found a positive effect for the active interventions on IPA at any follow-up point.

AB - This edition of Multiple Sclerosis Journal includes reports from three randomised controlled trials (RCTs) of cognitive behaviour therapy1, aerobic training2 and energy conservation3 management for the treatment of MS fatigue. The three trials were led by separate research teams as part of the Dutch TREFAMS-ACE consortium4. Each trial compared one of the active treatments against a standardised control condition of three 45-minute individual face-to-face consultations with experienced and trained MS-nurses over a 4-month period. The MS nurses gave patients a standardised brochure about fatigue. Patients had the opportunity to discuss their fatigue and set goals for managing fatigue. In contrast, the three active treatments (summarised in the Table) included 12 45 minute individual face-to face treatment sessions with a health professional over the same time period. Participants in all three trials were followed up over 12-months. The primary outcomes, Checklist Individual Strengths (CIS20r)5 domain fatigue and Impact on Participation and Autonomy Questionnaire (IPA) 6 were identical in all studies. Secondary outcomes included the Modified Fatigue Impact Scale7 and the Fatigue Severity Scale8. ECM showed no significant improvements over the control condition on any outcomes. The CBT and aerobic training RCTS reported positive effects on the primary and secondary fatigue measures at the end of treatment, but effects were lost at 52-weeks follow-up. None of the trials found a positive effect for the active interventions on IPA at any follow-up point.

KW - Multiple Sclerosis

KW - CBT

KW - MS fatigue

KW - aerobic training

UR - http://www.scopus.com/inward/record.url?scp=85030100922&partnerID=8YFLogxK

U2 - 10.1177/1352458517731159

DO - 10.1177/1352458517731159

M3 - Article

VL - 23

SP - 1436

JO - Multiple Sclerosis Journal

JF - Multiple Sclerosis Journal

IS - 11

ER -