Which exercise and behavioural interventions show most promise for treating fatigue in multiple sclerosis? A network meta-analysis
Journal article
Harrison, Anthony M, Safari, Reza, Mercer, Tom, Picariello, Federica, van der Linden, Marietta L, White, Claire, Moss-Morris, Rona and Norton, Sam 2021. Which exercise and behavioural interventions show most promise for treating fatigue in multiple sclerosis? A network meta-analysis. Multiple Sclerosis Journal. https://doi.org/10.1177/1352458521996002
| Authors | Harrison, Anthony M, Safari, Reza, Mercer, Tom, Picariello, Federica, van der Linden, Marietta L, White, Claire, Moss-Morris, Rona and Norton, Sam |
|---|---|
| Abstract | Fatigue is a common, debilitating symptom of multiple sclerosis (MS) without a current standardised treatment. Nine electronic databases up to August 2018 were searched, and 113 trials (n = 6909) were included: 34 were fatigue-targeted and 79 non-fatigue-targeted trials. Intervention characteristics were extracted using the Template for Intervention Description and Replication guidelines. Certainty of evidence was assessed using GRADE. Pairwise meta-analyses showed that exercise interventions demonstrated moderate to large effects across subtypes regardless of treatment target, with the largest effect for balance exercise (SMD = 0.84). Cognitive behavioural therapies (CBTs) showed moderate to large effects (SMD = 0.60), with fatigue-targeted treatments showing larger effects than those targeting distress. Network meta-analysis showed that balance exercise performed significantly better compared to other exercise and behavioural intervention subtypes, except CBT. CBT was estimated to be superior to energy conservation and other behavioural interventions. Combined exercise also had a moderate to large effect. Treatment recommendations for balance and combined exercise are tentative as the certainty of the evidence was moderate. The certainty of the evidence for CBT was high. |
| Keywords | Neurology; Clinical Neurology; Fatigue; Multiple Sclerosis; Network Meta-anlalysis; Randomised Controlled Trials; Behavioural Interventions; Exercise Interventions; TIDieR |
| Year | 2021 |
| Journal | Multiple Sclerosis Journal |
| Publisher | SAGE Publications |
| ISSN | 1352-4585 |
| 1477-0970 | |
| Digital Object Identifier (DOI) | https://doi.org/10.1177/1352458521996002 |
| Web address (URL) | http://hdl.handle.net/10545/625735 |
| http://creativecommons.org/publicdomain/zero/1.0/ | |
| hdl:10545/625735 | |
| Publication dates | 20 Apr 2021 |
| Publication process dates | |
| Deposited | 29 Apr 2021, 14:32 |
| Accepted | 29 Jan 2021 |
| Rights | CC0 1.0 Universal |
| Contributors | University of Derby |
| File | File Access Level Open |
| File | File Access Level Open |
| File |
Permalink -
https://repository.derby.ac.uk/item/9351v/which-exercise-and-behavioural-interventions-show-most-promise-for-treating-fatigue-in-multiple-sclerosis-a-network-meta-analysis
Download files
39
total views33
total downloads2
views this month1
downloads this month
Export as
Related outputs
Understanding the attitudes towards breastfeeding amongst staff and students in a UK higher institutional setting–a mixed-method cross-sectional study
Jackson, J., Hallam, J., Griffiths, A., Leverton, J. and Safari, R. 2023. Understanding the attitudes towards breastfeeding amongst staff and students in a UK higher institutional setting–a mixed-method cross-sectional study. International Journal of Health Promotion and Education . pp. 1-12. https://doi.org/10.1080/14635240.2023.2273263Comprehensive geriatric assessment delivered by advanced nursing practitioners within primary care setting: a mixed-methods pilot feasibility randomised controlled trial
Safari, R., Jackson, J. and Boole, L. 2023. Comprehensive geriatric assessment delivered by advanced nursing practitioners within primary care setting: a mixed-methods pilot feasibility randomised controlled trial. BMC Geriatrics . 23 (513), pp. 1-14. https://doi.org/10.1186/s12877-023-04218-0The effects of a custom foot orthosis on dynamic plantar pressure in patients with chronic plantar fasciitis: A randomized controlled trial
Nakhaee, M., Mohseni-Bandpei, M., Mousavi, M.E., Shakourirad, A., , x, Amiri, H. and Nakhaei, M., Safari, R., Mimar, R., Amiri, H. and Nakhaei, M. 2022. The effects of a custom foot orthosis on dynamic plantar pressure in patients with chronic plantar fasciitis: A randomized controlled trial. Prosthetics and Orthotics International. https://doi.org/10.1097/PXR.0000000000000179A narrative synthesis using the ecological systems theory for understanding a woman’s ability to continue breastfeeding
Jackson, J., Safari, R. and Hallam, J. 2022. A narrative synthesis using the ecological systems theory for understanding a woman’s ability to continue breastfeeding. International Journal of Health Promotion and Education. https://doi.org/10.1080/14635240.2022.2098162
Lower limb prosthetic interfaces: Clinical and technological advancement and potential future direction
Safari, Reza 2020. Lower limb prosthetic interfaces: Clinical and technological advancement and potential future direction. Prosthetics and Orthotics International. https://doi.org/10.1177/0309364620969226Prevalence of pressure ulcers in Africa: A systematic review and meta-analysis
Anthony, Denis, Alosaimi, Dalyal, Korsah, Kwadwo, Safari, Reza and Shiferaw, Wondimeneh Shibabaw 2021. Prevalence of pressure ulcers in Africa: A systematic review and meta-analysis. Journal of Tissue Viability. https://doi.org/10.1016/j.jtv.2020.10.003Prevalence of pressure ulcers in long term care: A global review.
Anthony, Denis, Alosoumi, Dalyal and Safari, Reza 2019. Prevalence of pressure ulcers in long term care: A global review. Journal of Wound Care. https://doi.org/10.12968/jowc.2019.28.11.702Prevalence of heat and perspiration discomfort inside prostheses: literature review.
Ghoseiri, K and Safari, Reza 2014. Prevalence of heat and perspiration discomfort inside prostheses: literature review. Journal of Rehabilitation Research and Development. https://doi.org/10.1682/JRRD.2013.06.0133Application of ultrasound in the assessment of plantar fascia in patients with plantar fasciitis: a systematic review
Mohseni-Bandpei, M.A, Nakhaee, M, Mousavi, M.E, Shakourirad, A, Safari, Reza and Kashani, R.V 2014. Application of ultrasound in the assessment of plantar fascia in patients with plantar fasciitis: a systematic review. Ultrasound in Medicine and Biology. https://doi.org/10.1016/j.ultrasmedbio.2014.03.001The prototype of a thermoregulatory system for measurement and control of temperature inside prosthetic socket
Ghoseiri, Kamiar, Ghoseiri, K, Zheng, Y.P, Hing, L.T, Safari, Reza and Leung, A.K.L 2015. The prototype of a thermoregulatory system for measurement and control of temperature inside prosthetic socket. Sage. https://doi.org/10.1177/0309364615588343Temperature measurement and control system for transtibial prostheses: single subject clinical evaluation.
Ghoseiri, Kamiar, Zheng, Yong Ping, Leung, Aaron K L, Rahgozar, Mehdi, Aminian, Gholamreza, Masoumi, Mehdi and Safari, Reza 2016. Temperature measurement and control system for transtibial prostheses: single subject clinical evaluation. Assistive technology : the official journal of RESNA. https://doi.org/10.1080/10400435.2016.1272070Temperature measurement and control system for transtibial prostheses: functional evaluation.
Ghoseiri, Kamiar, Zheng, Yong Ping, Leung, Aaron K L, Rahgozar, Mehdi, Aminian, Gholamreza, Lee, Tat Hing and Safari, Reza 2016. Temperature measurement and control system for transtibial prostheses: functional evaluation. Assistive technology : the official journal of RESNA. https://doi.org/10.1080/10400435.2016.1225850Socket interface pressure and amputee reported outcomes for comfortable and uncomfortable conditions of patellar tendon bearing socket: a pilot study
Safari, Reza, Tafti, Nahid and Aminian, Gholamreza 2015. Socket interface pressure and amputee reported outcomes for comfortable and uncomfortable conditions of patellar tendon bearing socket: a pilot study. Assistive Technology. https://doi.org/10.1080/10400435.2014.949016Which behavioural and exercise interventions targeting fatigue show the most promise in multiple sclerosis? A systematic review with narrative synthesis and meta-analysis
Moss-Moris, R, Harrison, A.M, Safari, Reza, Norton, S, van der Linden, M.L, Picariello, F, Thomas, S, White, C, Mercer, T and Rona, Moss-Morris 2019. Which behavioural and exercise interventions targeting fatigue show the most promise in multiple sclerosis? A systematic review with narrative synthesis and meta-analysis. Behaviour Research and Therapy. 137, pp. 1-19. https://doi.org/10.1016/j.brat.2019.103464Fatigue interventions in long term, physical health conditions: a scoping review of systematic reviews.
Hulme, Katrin, Safari, Reza, Thomas, Sarah, Mercer, Tom, White, Claire, Van der Linden, Marietta and Moss-Morris, Rona 2018. Fatigue interventions in long term, physical health conditions: a scoping review of systematic reviews. PLos ONE. https://doi.org/10.1371/journal.pone.0203367A systematic review of variables used to assess clinically acceptable alignment of unilateral transtibial amputees in the literature.
Tafti, Nahid, Hemmati, Fatemeh, Safari, Reza, Karimi, Mohammad Taghi, Farmani, Farzad, Khalaf, Ali and Mardani, Mohammad Ali 2018. A systematic review of variables used to assess clinically acceptable alignment of unilateral transtibial amputees in the literature. Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine. https://doi.org/10.1177/0954411918789450Development and preliminary evaluation of a new anatomically based prosthetic alignment method for below-knee prosthesis.
Tafti, Nahid, Karimlou, Masoud, Mardani, Mohammad Ali, Jafarpisheh, Amir Salar, Aminian, Gholam Reza and Safari, Reza 2018. Development and preliminary evaluation of a new anatomically based prosthetic alignment method for below-knee prosthesis. Assistive technology : the official journal of RESNA. https://doi.org/10.1080/10400435.2018.1467513Digital interventions to promote self-management in people with osteoarthritis: systematic review and meta-analysis - Study protocol
Safari, Reza, Jackson, Jessica, Dhadda, Buk, Watkins, Merryl, Sheffield, David, Anthony, Denis and Ward, Derek 2018. Digital interventions to promote self-management in people with osteoarthritis: systematic review and meta-analysis - Study protocol. National Health Service (NHS).