What is the effectiveness of non-pharmacological, therapeutic interventions on decreased fatigue levels of adults with multiple sclerosis?

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Ludwig, McKenna
Banfield, Allison
Hudlow, Maddy
Thorp, Sheridan
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Therapeutic , Interventions , Fatigue , Multiple Sclerosis
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What is the effectiveness of non-pharmacological, therapeutic interventions on decreased fatigue levels of adults with multiple sclerosis?   ABSTRACT BACKGROUND: Multiple sclerosis (MS) is an immune-mediated disease that attacks the central nervous system (CNS). In the United States, approximately one million people have been diagnosed with MS, with the typical diagnosis age being from 20 to 50 years. Typical symptoms of MS include fatigue, pain, blindness, mood changes, numbness, or memory deficits with fatigue being one of the most significant symptoms for adults with MS. Fatigue negatively impacts an individual’s ability to complete occupations at home, work, and other community environments. AIM: This critically appraised topic (CAT) is aimed at determining the effectiveness of non-pharmacological interventions in decreasing fatigue levels in adults with multiple sclerosis (MS). METHODS: Literature search analysis led to the inclusion of Level 1A, 1B, and 2B studies focusing on the prioritized aim. Studies were further analyzed to include literature within the last four years that met the following criteria: adults with MS participating in non-pharmacological, therapeutic interventions to decrease levels of fatigue. RESULTS: Level 1A, 1B, and 2B research completed on non-pharmacological, therapeutic interventions has revealed moderate, positive evidence regarding the effectiveness of non-pharmacological, therapeutic interventions on decreasing levels of fatigue. The strongest evidence was found for exercise-based interventions including high-intensity interval training, progressive resistance training, sensory-motor training, and aquatic-based therapy. Education-based interventions including individual cognitive behavioral therapy (CBT) sessions, family-centered self-care educational programs, educational diet programs, and inpatient energy management education programs also showed effectiveness in decreasing fatigue levels. RCTs with larger sample sizes and different non-pharmacological, therapeutic interventions as well as further systematic reviews should be conducted to increase the strength of evidence for non-pharmacological, therapeutic interventions.
Creighton University
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