Multiple Sclerosis International / 2014 / Article / Tab 2 / Review Article
Meta-Analysis of Three Different Types of Fatigue Management Interventions for People with Multiple Sclerosis: Exercise, Education, and Medication Table 2 Corresponding table for forest plots.
1st author Experimental intervention Comparison intervention Outcome measure ES 95% CI Exercise intervention trials Kargarfard [25 ] Aquatic exercise No intervention MFIS 2.05 1.00–3.11 Hebert [26 ] Vestibular rehabilitation Endurance and stretch exercise MFIS 1.83 0.90–2.77 Velikonja [27 ] Climbing Yoga MFIS 0.21
−0.69–1.11 Dalgas [28 ] Progressive resistance training No intervention FSS 0.81 0.08–1.15 Mostert [29 ] Bicycle aerobic exercise No intervention FSS 0.34 −0.43–1.11 van den Berg [30 ] Treadmill Walking No intervention FSS 0.01 −0.96–0.99 Klefbeck [31 ] Inspiratory muscle exercise Usual care FSS 1.01 −0.06–2.09 Cakt [32 ] Cycling progressive resistance training Home exercise for lower limb muscle strength and balance FSS 0.20 −0.60–1.02 Hayes [33 ] High intensity resistance training plus standard exercise Standard exercise FSS −0.24 −1.15–0.64 Oken [34 ] Aerobic exercise Yoga MFI −0.17 −0.82–0.48 Pooled ES Random effects 0.57 0.10–1.04 (P = 0.02) Educational intervention trials Finlayson [35 ] Fatigue management (teleconference) Waitlisted FIS 0.53 0.19–0.86 Mathiowetz [36 ] Energy conservation course (in-person) Waitlisted FIS 0.42 0.08–0.76 Hugos [37 ] Take control Waitlisted MFIS 0.43 −0.29–1.57 Grossman [38 ] Mindfulness intervention Usual care MFIS 0.42 0.09–0.74 Kos [39 ] Multidisciplinary Fatigue management Placebo (nonfatigue focused program) MFIS −0.16 −0.72–0.38 Moss-Morris [40 ] Cognitive Behavioral Therapy (CBT) Standard care MFIS 1.11 0.43–1.78 van Kessel [41 ] CBT Relaxation FS 0.99 0.50–1.48 Mohr [42 ] CBT Group Psychotherapy FAI 0.80 0.19–1.42 Pooled ES Random effects 0.54 0.30–0.77 (P < 0 .001) Pharmacological intervention trials Shaygannejad [43 ] Amantadine Aspirin FSS −0.21 −0.76–0.32 Tomassini [44 ] Amantadine ALCAR FSS −0.59 −1.26–0.06 Ashtari [45 ] Amantadine Placebo FSS 0.55 −0.06–1.16 Krupp† [46 ] Amantadine Placebo FSS 0.24 −0.23–0.73 The Canadian MS Research Group [47 ] Amantadine Placebo VAS (0–50 mm) 0.21 −0.08–0.51 Möller [48 ] Modafinil Placebo FSS 0.50 0.13–0.86 Stankoff† [49 ] Modafinil Placebo MFIS −0.33 −0.70–0.02 Pooled ES Random effects 0.07 −0.22–0.37 (P = 0.63)
ES was estimated using the published graphical data presented in the article; CBT: cognitive behavioral therapy; MFIS: Modified Fatigue Impact Scale; FSS: Fatigue Severity Scale; MFI: Multidimensional Fatigue Inventory; FIS: Fatigue Impact Scale; FS: Fatigue Scale; FAI: Fatigue Assessment Instrument.