The Added Value of Cognition-targeted Exercise Versus Symptom-targeted Exercise for Multiple Sclerosis Fatigue
Condition: Physical and Rehabilitation Medicine
MeSH terms: Multiple Sclerosis; Sclerosis; Fatigue
Study type: Interventional

Summary: 
      Introduction: Multiple sclerosis (MS) has a wide range of physiological and
      neuropsychological symptoms. Over 75% of MS patients complain about fatigue, which for many
      is one of their most debilitating symptoms, having a substantial impact on their quality of
      life and ability to carry out day-to-day tasks. Previous investigations on the effectiveness
      of different types of psychotherapy on MS fatigue are extremely limited. The aim of this
      study was to investigate the added value of cognition-targeted exercise versus
      symptom-targeted exercise for Multiple Sclerosis fatigue
    

Detailed description: 
      Patients with fatigue symptoms (score of ≥5 on Fatigue Scale) will be randomly assigned into
      experimental (n=30) and control (n=30) groups. The subjects in the experimental group will
      receive eight 50-minute sessions of weekly cognitive behavior therapy based on van Kessel's
      model in addition cognition-targeted exercise program , whereas the patients in the control
      group will receive eight 50-minute sessions of weekly CBT in addition to standardized
      physiotherapy program . A standardized program of physiotherapy exercises will consist of
      twice-weekly supervised general aerobic, strengthening and flexibility exercise sessions.
      This exercise program is reflective of the general exercises typically undertaken within
      routine clinical practice.
    

Intervention name(s): cognition-targeted exercise; Cognitive behavioral therapy; Standardized physical therapy
Intervention type(s): Other; Behavioral; Other
Intervention description(s): All Standardized physical therapy exercises will be performed in a time-contingent .
Goal setting is essentially done together with the patient, focussing on functionality instead of fatigue relief. Progression to a next level of (more difficult) exercises will be preceded by an intermediate phase of motor imagery.
The treating physical therapist will be advised to address patients' cognitions about their problems during the cognition-targeted exercise training, so that patients will have positive perceptions regarding their illness and treatment outcome.
The treating physical therapist will be advised to discuss the patient's perceptions about each exercise. This include discussion of the anticipated consequences of the exercises and challenging the patient's cognitions in relation to the exercises; In the first and second sessions, patients will learn about fatigue-related symptoms as well as Cognitive behavioral therapy and its effectiveness. The third and fourth sessions will be devoted on the introduction of behavioral strategies. The fifth session will introduce cognitive strategies to decrease fatigue. The last three sessions will be about how to adopt the proposed strategies consistently.; The standardized physical therapy will consist of eight half-hour individualized face to face physiotherapy sessions, over a 4-week period. this program will consist of twice-weekly supervised general aerobic, strengthening and flexibility exercise sessions .This exercise program is reflective of the general exercises typically undertaken within routine clinical practice.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: A prospective, parallel-group, randomized clinical trial participants will be randomly assigned to the control group or intervention group.
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Randomized controlled trial; Multiple Sclerosis; Fatigue; Cognitive Behavioral Therapy; exercise