Relationship between exercise stimulation, fatigue, and bodily exercise in MS

Interventions to manage fatigue through activity stimulation and to improve physical activity may benefit patients with multiple sclerosis (MS), research published in the Journal of Functional Morphology and Kinesiology shows.

The study researchers tried to assess the links between stimulation, fatigue, and physical activity in people with MS. They carried out a cross-sectional study as part of a multi-center longitudinal study (rehabilitation, sport and active lifestyle) [ReSpAct] Study), which focused on the nationwide implementation of an active lifestyle in patients with chronic diseases. A total of 80 patients (> 18 years of age) who had a diagnosis of MS, were receiving rehabilitation or medication, and were participating in an active lifestyle program were included in the study. Patients had a mean age of 44 years (standard deviation) [SD]± 11 years and 75 percent were female (n = 60).

Patients received either inpatient or outpatient rehabilitation and were assessed on a baseline measurement (3 to 6 weeks before discharge) of activity stimulation behavior, fatigue, physical activity, and health-related quality of life (QoL) selected from the ReSpAct dataset . Patients completed questionnaires to determine the level of activity performed and the pace, risk of overactivity and fatigue. Background demographic information included age, gender, body mass index (BMI), health-related quality of life and the risk of overactivity.

In 91.3 percent of the patients (n = 73) a clinically significant severity scale for fatigue (FSS score> 4) was determined. Although the variables were not highly correlated, fatigue and health-related quality of life had the highest modest correlation (r = -0.41) [β=-0.341; t=-2.57, P =0.03]), followed by commitment to stimulation and health-related quality of life (r = -0.27) and commitment to stimulation and fatigue (r = 0.27) [β=0.198; t=1.43, P =0.16]). The correlations between stimulation and physical activity (r = -0.25[β=-0242;t=-161P=012)showednoassociationsbetweenthetwoNoneofthedemographiccharacteristicsrelatedtophysicalactivity(P≥005)stimulationandage(r=024)bothfollowed(r=0nivariatecorrelations0242;t=-161P=012)showednoassociationsbetweentwoNoneofthedemographicsconnectedtophysicalactivity(P≥005)pacingandage(r=024)followedOtherbivariatecorrelationsmaintainedamodestlevel(r≤±022)[β=-0242;t=-161P=012)zeigtenkeineAssoziationenzwischenbeidenKeinederdemografischenMerkmaleimZusammenhangmitkörperlicherAktivität(P≥005)StimulationundAlter(r=024)folgtenAnderebivariateKorrelationenbehielteneinbescheidenesNiveaubei(r≤±022)[β=-0242;t=-161P=012)showednoassociationsbetweenthetwoNoneofthedemographicsconnectedtophysicalactivity(P≥005)Pacingandage(r=024)followedOtherbivariatecorrelationsmaintainedamodestlevel(r≤±022)

Patients with MS exhibited significant symptoms of fatigue, and a moderate negative association between fatigue and health-related quality of life indicated high fatigue, which correlated with low health-related quality of life. In addition, study researchers found that the negative association between stimulation and health-related quality of life suggests that high engagement with stimulation correlates with low health-related quality of life.

Limitations included the size of the study, the lack of information about the MS type and disability, and the inability to extrapolate the results to other populations. The process of self-reporting may also have resulted in bias due to under-reporting or over-reporting.

The lack of an association between stimulation and fatigue and / or physical activity indicated that patients with MS need to establish appropriate strategies for physical activity. The study’s researchers concluded that, ultimately, “the potential needs to be explored to provide advice and guidance to people with MS on activity stimulation and to develop therapeutic interventions”.


Abonie US, Hoekstra F, Seves BL, Woude LHVvd, Dekker R, Hettinga FJ. Associations between activity stimulation, fatigue, and physical activity in adults with multiple sclerosis: a cross-sectional study. J. funct. Morphol. Published online June 15, 2020; 5 (2): 43. doi: 10.3390 / jfmk5020043

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