Journal of Neurology

, Volume 265, Issue 6, pp 1328–1333 | Cite as

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

  • Giancarlo Coghe
  • Federica Corona
  • Elisabetta Marongiu
  • Giuseppe Fenu
  • Jessica Frau
  • Lorena Lorefice
  • Antonio Crisafulli
  • Manuela Galli
  • Alberto Concu
  • Maria Giovanna Marrosu
  • Massimiliano Pau
  • Eleonora Cocco
Original Communication



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.


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.


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).


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.


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.


Physical activity Multiple sclerosis Fatigue MFIS Processing speed 


Compliance with ethical standards

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.


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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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Giancarlo Coghe
    • 1
  • Federica Corona
    • 2
  • Elisabetta Marongiu
    • 3
  • Giuseppe Fenu
    • 1
  • Jessica Frau
    • 1
  • Lorena Lorefice
    • 1
  • Antonio Crisafulli
    • 3
  • Manuela Galli
    • 4
  • Alberto Concu
    • 3
  • Maria Giovanna Marrosu
    • 1
  • Massimiliano Pau
    • 2
  • Eleonora Cocco
    • 1
  1. 1.Department of Medical Sciences and Public Health, Multiple Sclerosis CenterUniversity of CagliariCagliariItaly
  2. 2.Department of Mechanical, Chemical and Materials EngineeringUniversity of CagliariCagliariItaly
  3. 3.Sports Physiology Lab, Department of Medical Sciences and Public HealthUniversity of CagliariCagliariItaly
  4. 4.Department of Electronics, Information and BioengineeringPolitecnico di MilanoMilanItaly

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