Meta-Analysis of Three Different Types of Fatigue Management Interventions for People with Multiple Sclerosis: Exercise, Education, and Medication

Table 3

Table of active interventions and their participants of the trials included in the review.

Study	Intervention		Participants
1st author	Detail		Number of participants per group	Mean age	% women	Disability (EDSS)	MS type; (% RRMS)	Mean years since diagnosis
Exercise intervention trials
Kargarfard [25]	Aquatic exercise	60 min,; 3x/week,; 10 weeks	10	34	100	3	100%	5
Hebert [26]	Vestibular rehabilitation program, plus a 5 min fatigue education	60 min,; 2x/week,; 6 weeks	12	47	75	Criterion: able to walk 100 m	92%	6.5
Velikonja [27]	Climbing	1x/week,; 10 weeks	10	42^†	Unclear	4^†	Unclear	Unclear
	Yoga	1/week, 10 weeks	10	41^†		4^†
Dalgas [28]	Progressive resistance training	2x/week,; 12 weeks	15	48	67	3.7	100%	7
Mostert [29]	Aerobic exercise (bicycle)	30 min, 5x/week,; 3-4 weeks.	13	45	77	4.6	31%	11
van den berg [30]	Treadmill walking	Up to 30 min,; 3x/week,; 4 weeks	8 (immediate); 8 (delayed)	30–65 (range)	88%	Criterion: able to walk 10 meter <60 second	Unclear	Unclear
Klefbeck [31]	Inspiratory muscle training	70 sessions (total),; 2x/day,; 3-4/week,; 10 weeks	7	46^†	86	7.5^†	Unclear	12^†
Cakt [32]	Cycling progressive resistance training	2x/week,; 8 weeks	14	36	64	Criterion: EDSS ≤ 6	Unclear	8
	Home-based exercise	2x/week,; 8 weeks	10	43	80		Unclear	6
Hayes [33]	Resistance training (electronic ergometer)	45–60 min, 3x/week,; 12 weeks	9	48	55.5	5	Unclear	12.5
	Standard exercise (aerobic, stretch, strengthening, and balance)	3x/week,; 12 weeks	10	50	60	5	Unclear	12
Oken [34]	Yoga	90 min, 1x/week,; 24 weeks	22	50	91	3.2	Unclear	Unclear
	Aerobic exercise (bicycle)	1x/week,; 24 weeks	15	49	87	3
Educational intervention trials
Finlayson [35]	Teleconference fatigue management program	70 min,; 1x/week,; 6 weeks	89 (immediate); 92 (delayed)	56^x	79^x	4 (PDDS)^x	52%^x	15^x
Mathiowetz [36]	Energy conservation course	120 min,; 1x/week,; 6 weeks	78 (immediate); 91 (delayed)	48^x	83^x	Unclear	61.5%^x	9.5^x
Hugos [37]	Take control program	120 min, 1x/week, 6 weeks	15	55	87	5	Unclear	14
Grossman [38]	Mindfulness intervention	150 min, 1x/week, 8 weeks; One 420 min session; 40 min/day homework	76	46	78	3	79%	8
Kos [39]	Multidisciplinary fatigue management	120 min,; 1x/week, 4 weeks	28	43	71	Criterion: able to walk 100 meter without aid	72%	6
Moss-Morris [40]	CBT	25–50 min,; 1x/week,; 8–10 weeks	23	40	70	38%; Able to walk 500 m or more	43.5%	21
van Kessel [41]	CBT	~50 min,; 1x/week,; 8 weeks	35	43	80	3	66%	5.5
	Relaxation therapy	~50 min,; 1x/week,; 8 weeks	37	47	70	4	49%	7
Mohr [42]	CBT	50 min, 1x/week, 16 weeks	22	45^x	72^x	2.5 (AI)^x	Unclear	8.5^x
	Supportive expressive group psychotherapy	90 min,; 1x/week,; 16 weeks	22
Pharmacological intervention trials
Shaygannejad [43]	Amantadine		26	36	85	1.5	85	3
Tomassini [44]	Amantadine		18	43	67	3	61	10
Ashtari [45]	Amantadine		21	26	33	2	100	6
Krupp [46]	Amantadine		31	40	68	3	90	11
The Canadian MS Research Group^x [47]	Amantadine		86	40	59	4	48	8
Möller [48]	Modafinil		62	41	63	3.5	47	7
Stankoff [49]	Modafinil		59	44	61	3.5	64	Unclear

xData based on the entire efficacy study sample; ^†Median; AI: Ambulation Index (mild to moderate gait impairment).