Fatigue is one of the most prominent symptoms in Multiple Sclerosis Patients, occurring in 80% of patients worldwide (National MS Society, 2020). The cause of the invisible MS fatigue symptom is unknown and can be detrimental to a person's quality of life. In MS there is a special type of fatigue called “lassitude” or MS fatigue. This type of severe progressive fatigue occurs daily, can occur even after a good night of sleep and is negatively affected by heat. Primary MS fatigue is due to the damage that affects nerve signaling from the brain to the rest of the body, making it difficult to carry out simple tasks (International MS Federation, 2023). Secondary MS fatigue is a result of the symptoms of MS such as sleep disturbance from muscle spasms. Marie, a patient of MS since 2016 spoke about the difficulties of fatigue as “your body falls asleep for you, but your head doesn’t fall asleep” and “even sleeping is also too difficult, because your body has gone out but not your head.” To counter this symptom that affects a majority of MS patients, new scientific studies have been conducted for effective treatment. Recent studies include bright light therapy and intensive cycling therapy.
A promising small clinical trial was sponsored by the Medical University of Virginia involving 26 patients with several MS forms. All test patients were ruled out for any sleeping disorders that regularly lead to fatigue. Bright light therapy (BLT) was used, involving a machine that produces intense and constant light. Two groups were aimlessly created and each subject was given a BLT machine to use for 30 minutes each morning for two weeks (Wexler, 2022). One group was given a normal, unmodified BLT that emitted bright light and the other group was given a BLT that produced dimmer red light. The conductors of this trial were looking for a clinically meaningful change of 4.05 points using the Fatigue Severity Scale (FFS) score. For the red light BLT machines, patients' scores were recorded at 48 and decreased to 46.08 at the end of the trial period (Wexler, 2022). The other trial group's FSS score decreased from to 39.62 after two weeks, producing a clinically significant change (Wexler, 2022). Since the trial was of a small scale, the mathematical implications could mean the results were up to variable factors and not clinically meaningful. However, this study has opened the door to potential research for light therapy to counteract MS symptoms.
A 12-week moderate to intense cycling program was designed for a small pilot clinical trial with 18 MS patients conducted at Ohio MS Clinic, resulting in a noticeable decrease in fatigue. The routine consisted of 45-minute sessions twice a week. Participants were mostly female, around the age of 55. One had primary progressive MS, seven had secondary progressive MS, and 10 had relapsing-remitting MS (Inacio, 2023). The patients recorded their fatigue using a Modified Fatigue Impact Scale (MFIS). In individuals with MS, patients are susceptible to physical impairment, muscle spasticity, pain symptoms, and heat sensitivity which all limit their ability to remain active. However, muscle weakness, pain and fatigue are also the most common symptoms of MS and aerobic exercise is commonly found to help fatigue and pain. In this trial, the control group was MS patients who were self-pedaling and the other group was a forced exercise group. The forced aerobic exercise group used a motor to lower the effort at which patients pedal to aid with physical impairments. The cycle was designed to make patients cycle at 70 rotations per minute at the least, allowing them to reach the intensity level to improve fatigue (Inacio, 2023). Fatigue levels at the end of the 12 weeks decreased from 29.1 to 17 and pain intensity scores also decreased from 3.5 to 2.8 (Inacio, 2023). The forced exercise group did not have different results than the control group however, many patients found it easier to participate in healthy exercise using the forced exercise cycle. As fatigue continues to impair the livelihood of many MS patients, several new methods are being researched to improve their quality of life.
References
Inacio, P. (2023, December 4). Cycling at aerobic pace eases fatigue and pain of MS in pilot study. Multiple Sclerosis News Today. Retrieved December 29, 2023, from https://multiplesclerosisnewstoday.com/news-posts/2023/12/04/cycling-aerobic-pace-eases-fatigue-pain-ms-pilot-study/
International MS Federation. (2023). Fatigue:. MS International Federation. Retrieved December 29, 2023, from https://www.msif.org/wp-content/uploads/2020/04/MS-FATIGUE-BOOKLET-WEB-1.pdf
National MS Society. (2020). Fatigue - MS Symptoms & Signs of MS. National MS Society. Retrieved December 29, 2023, from https://www.nationalmssociety.org/Symptoms-Diagnosis/MS-Symptoms/Fatigue
Wexler, M. (2022, December 14). Bright Light Therapy Shows Promise for Easing MS Fatigue in Small... Multiple Sclerosis News Today. Retrieved December 29, 2023, from https://multiplesclerosisnewstoday.com/news-posts/2022/12/14/bright-light-therapy-shows-promise-easing-fatigue-small-trial/
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