Effects of multidisciplinary rehabilitation on chronic fatigue in multiple sclerosis: a randomized controlled trial

PLoS One. 2014 Sep 18;9(9):e107710. doi: 10.1371/journal.pone.0107710. eCollection 2014.

Abstract

Background: Several rehabilitation programmes aim at reducing the impact of fatigue in MS patients. Acute and chronic fatigue should require different management.

Objectives: To assess the effects of individually tailored, multidisciplinary outpatient rehabilitation (MDR) on chronic fatigue.

Methods: Forty-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).

Results: The 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.

Conclusion: 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.

Trial registration: controlled-trials.com ISRCTN05017507.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Chronic Disease
  • Consultants
  • Fatigue / complications
  • Fatigue / rehabilitation*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multiple Sclerosis / complications
  • Multiple Sclerosis / physiopathology
  • Multiple Sclerosis / rehabilitation*
  • Nurses
  • Occupational Therapy
  • Physical Therapy Modalities
  • Treatment Outcome

Associated data

  • ISRCTN/ISRCTN05017507

Grants and funding

This study was supported by the Dutch MS Research Foundation ‘Stichting (project number 04-553 MS) http://msresearch.nl/. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.