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Fatigue, as measured using the Modified Fatigue Impact Scale, is a predictor of processing speed improvement induced by exercise in patients with multiple sclerosis: data from a randomized controlled trial

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Abstract

Background

Few studies have evaluated the impact of physical activity (PA) on cognition and fatigue, and none have considered the effects of PA on the relationship between cognition and fatigue.

Objectives

We evaluated the effect of PA in people with multiple sclerosis (pwMS) in a 6-month-long single-blind randomized controlled trial. We focused on the impact of exercise on cognition, fatigue, and the relationship between cognition and fatigue.

Methods

We recruited pwMS, who were then randomly assigned 1:1 to either a PA protocol group or a control group (CG). All patients underwent assessments using the Brief International Cognitive Assessment for Multiple Sclerosis including symbol digit modality test (SDMT), Berg Balance Scale (BBS), gait analysis, 6-Minute Walk Test, Timed Up and Go (TUG) test, and the Modified Fatigue Impact Scale (MFIS) at the beginning of the study (T0), at the end of the study (EOS) 24 weeks after T0, and at 24 weeks following the EOS (FU).

Results

A Wilcoxon test revealed a significant effect of exercise in the PA group, but not in the CG. Significant differences between T0 and EOS were found in the spatiotemporal parameters of gait, and performance on the SDMT, TUG, BBS, and MFIS. These differences were also present during the FU period. A regression model revealed that the baseline MFIS score predicted processing speed improvement (R2 = 0.65, p < 0.01), as the SDMT T score increased by 0.3 for each one-unit increase in the MFIS score at T0.

Conclusion

PA affects multiple aspects of the pathology in pwMS. Patients with greater fatigue must not be discouraged from exercise, as they may greatly benefit from PA. Specifically, PA was shown to improve information processing speed.

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Authors and Affiliations

  1. Department of Medical Sciences and Public Health, Multiple Sclerosis Center, University of Cagliari, Cagliari, Italy

    Giancarlo Coghe, Giuseppe Fenu, Jessica Frau, Lorena Lorefice, Maria Giovanna Marrosu & Eleonora Cocco

  2. Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Cagliari, Italy

    Federica Corona & Massimiliano Pau

  3. Sports Physiology Lab, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy

    Elisabetta Marongiu, Antonio Crisafulli & Alberto Concu

  4. Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy

    Manuela Galli

Authors
  1. Giancarlo Coghe
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  2. Federica Corona
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  3. Elisabetta Marongiu
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  4. Giuseppe Fenu
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  5. Jessica Frau
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  6. Lorena Lorefice
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  7. Antonio Crisafulli
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  8. Manuela Galli
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  9. Alberto Concu
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  10. Maria Giovanna Marrosu
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  11. Massimiliano Pau
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  12. Eleonora Cocco
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Corresponding author

Correspondence to Giancarlo Coghe.

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Conflicts of interest

The authors report no conflicts of interest.

Ethical standard

The study was carried out in compliance with the Declaration of Helsinki and was approved by the local ethics committee (approval no. 180; October 17, 2012).

Informed consent

Written informed consent was obtained from all participants.

Funding

This study was supported by the Region of Sardinia (Grant CRP-49712 “Adapted Physical Activity in Multiple Sclerosis in Sardinia”, L.R. 7/2007) and Fondazione Sardegna (Grants FBS 2012.0794 and FBS 2014.1175).

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Coghe, G., Corona, F., Marongiu, E. et al. Fatigue, as measured using the Modified Fatigue Impact Scale, is a predictor of processing speed improvement induced by exercise in patients with multiple sclerosis: data from a randomized controlled trial. J Neurol 265, 1328–1333 (2018). https://doi.org/10.1007/s00415-018-8836-5

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  • DOI: https://doi.org/10.1007/s00415-018-8836-5

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