Multiple Sclerosis Clinical Trial
Official title:
Feasibility Evaluation of a Tailored Exercise Intervention to Manage Fatigue in Progressive Multiple Sclerosis
Fatigue is one of the most common and debilitating symptoms of Multiple Sclerosis (MS). Exercise is suggested as a way to improve fatigue, but it is not clear what the effects of exercise are on fatigue - especially in people with progressive MS. Therefore, this study aims to test the feasibility of a tailored exercise programme to help improve fatigue in people with progressive MS. To do this people with progressive MS who are experiencing fatigue will be randomly allocated to receive either a tailored exercise programme, a standard exercise programme, or their usual care. Both exercise programmes will be 8 weeks long and require participants to attend Falkirk Community Hospital twice a week. The standard exercise programme involves a moderate intensity interval training session using a stationary exercise bike. The tailored exercise programme is similar to the standard exercise programme, as participants will be prescribed the same type and duration of exercise; however, the difference between the 2 programmes is that the intensity of exercise performed during each session of the tailored exercise programme is dictated by the participant's level of fatigue. Participants will complete an exercise test, walking test, and questionnaires relating to fatigue, quality of life, depression and anxiety, sleep quality, and cognition before and 1 week after completing the exercise programme.
This study aims to evaluate the feasibility of delivering a tailored exercise intervention to
manage fatigue in people with progressive forms of MS. To do this, a randomised controlled
trial design will be used to assess the feasibility of delivering a tailored exercise
intervention to manage fatigue in people with progressive forms of MS in comparison to a
standard (untailored) exercise group and usual care control group.
This study aims to recruit up to 45 people with progressive MS who are experiencing
moderate-severe levels of fatigue from MS clinics and outpatient physiotherapy services
within NHS Forth Valley. Participants will be randomly allocated to receive either the
tailored exercise programme, the standard exercise programme, or their usual care. All
outcome measures will be recorded at baseline and post-intervention.
Both exercise programmes will require participants to attend Falkirk Community Hospital twice
a week for 8 weeks - therefore, participants will receive 16 exercise sessions in total. All
exercise sessions will be supervised by a physiotherapist and they will provide participants
with any support that is required. The standard exercise programme involves aerobic-based
interval training delivered on a bicycle ergometer. Each exercise session will be 30 minutes
in duration, and will be broken down into a 3 minute warm-up, 24 minutes of interval
training, and a 3 minute cool-down. During the interval training component, participants will
be asked to perform 6 intervals that require them to exercise at a moderate intensity (>70%
heart rate reserve) for 2 minutes followed by 2 minutes of recovery.
The tailored exercise programme is similar to the standard exercise programme - participants
will still be required to attend Falkirk Community Hospital twice a week for 8 weeks, and
they will perform the same type and duration of exercise as the standard exercise programme.
However in order to tailor exercise to fatigue, participants will be asked to rate their
current levels of fatigue before exercising - this rating will then be compared to the
baseline score. If the participant's fatigue is worse, they will be offered the option of
performing a lower intensity of exercise for that specific session (>50% heart rate reserve).
In addition, participants will also be asked to monitor their fatigue in a symptom diary for
2 days following each exercise session. If fatigue is worsened by exercise and remains
elevated for 2 days after 2 consecutive exercise sessions, then they will also be offered the
option of performing the lower intensity exercise prescription.
Participants in the usual care control group will continue to receive their standard care
independent of this study. Participants will also receive an information booklet about
fatigue that is freely available from the UK MS Society. This booklet provides general
information about MS-related fatigue, strategies to self-monitor and self-manage symptoms,
and directs them to contact health professionals involved in their care for support if
required.
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