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neuroreha 2024; 16(02): 88-96
DOI: 10.1055/a-2221-9355
Originalarbeit

Die Auswirkungen von sporttherapeutischen Leistungen auf die Fatigue und Fatigability bei Personen mit Multipler Sklerose – eine systematische Übersichtsarbeit

Tamara Wiesenberg
1   SRH Hochschule für Gesundheit Gera
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Zusammenfassung

Einleitung Fatigue und Fatigability zählen mit 65% zu den häufigsten belastenden Symptomen bei Multipler Sklerose (MS).

Ziel Ziel dieser Übersichtsarbeit war es zu schauen, welche sporttherapeutischen Therapieinterventionen, unterteilt in Ausdauer-, Kraft- und Wassertraining, zu einer Reduktion der Fatigue bzw. Fatigability bei Personen mit Multipler Sklerose führen und welcher Ansatz bewährt ist.

Methode Die Literaturrecherche wurde auf den Datenbänken CENTRAL, PubMed und PEDRO durchgeführt. Es wurde nach randomisiert kontrollierten Studien gesucht, die eine sporttherapeutischen Trainingsintervention mit einer anderen Intervention bei Personen mit Multipler Sklerose untersucht haben. Primäre Zielparameter waren MFIS, FSS, FSMC, FKS und WEIMuS sowie der 6-MWT, 10-MWT und der Sit-to-Stand-Test.

Ergebnisse Es wurden 38 randomisiert kontrollierte Studien mit 2366 Probanden in die Untersuchung eingeschlossen. Die verschiedenen Interventionsmöglichkeiten wurden in die 5 Subgruppen „Ausdauertraining“, „Krafttraining“, „Kraft- und Ausdauertraining“, „Wassertherapie“ und „Robotergestützte Therapie“ eingeteilt. Es konnten in allen Bereichen signifikante Gruppenunterschiede zugunsten der Interventionsgruppe für eine oder mehrere primäre Zielparameter gemessen werden.

Fazit Es kann keine eindeutige Empfehlung für eine bestimmte spottherapeutische Therapieintervention zur Verbesserung der Fatigue ausgesprochen werden. Bei allen Interventionen wird eine Reduktion der Fatigue erzielt.

Abstract

Introduction At 65%, fatigue and fatigability are among the most common stressful symptoms in multiple sclerosis (MS).

Aim The aim of this review was to examine which sports therapy interventions, divided into endurance, strength and water training, lead to a reduction in fatigue and fatigability in people with multiple sclerosis and which approach has proven successful.

Methods The literature search was conducted on the CENTRAL, PubMed and PEDRO databases. We searched for randomized controlled trials that compared a sports therapy training intervention with another intervention in people with multiple sclerosis. Primary outcome measures were MFIS, FSS, FSMC, FKS and WEIMuS as well as the 6-MWT, 10-MWT and Sit to Stand.

Results 38 randomized controlled trials with 2366 subjects were included in the study. The different intervention options were divided into the 5 subgroups „endurance training“, „strength training“, „strength and endurance training“, „aquatic therapy“ and „robot-assisted therapy“. Significant group differences in favor of the intervention group for one or more primary target parameters were measured in all areas.

Conclusion No clear recommendation can be made for a specific sport therapy intervention to improve fatigue. A reduction in fatigue is achieved with all interventions.

Schlüsselwörter

Multiple Sklerose - Fatigue - Bewegungstherapie - Wassertherapie

Key words

Multiple sclerosis - fatigue - exercise therapy - water therapy


Publication History

Received: 15 October 2023

Accepted: 04 December 2023

Article published online:
06 June 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • Literatur

  • 1 Hemmer B et al. Diagnose und Therapie der Multiplen Sklerose, Neuromyelitis-optica-Spektrum-Erkrankungen und MOG-IgG-assoziierten Erkrankungen, S2k-Leitlinie, 2023. In: Deutsche Gesellschaft für Neurologie, Hrsg. Leitlinien für Diagnostik und Therapie in der Neurologie. Im Internet: www.dgn.org/leitlinien Stand: 20.03.2024
  • 2 Lublin FD, Reingold SC, Cohen JA. et al. Defining the clinical course of multiple sclerosis: The 2013 revisions. Neurology 2014; 83: 278-286
    CrossrefPubMedSearch in Google Scholar
  • 3 Kluger BM, Krupp LB, Enoka RM. Fatigue and fatigability in neurologic illnesses: Proposal for a unified taxonomy. Neurology 2013; 80: 409-416
    CrossrefPubMedSearch in Google Scholar
  • 4 Genova HM, Rajagopalan V, DeLuca J. et al. Examination of cognitive fatigue in multiple sclerosis using functional magnetic resonance imaging and diffusion tensor imaging. PLoS One 2013; 8: e78811
    CrossrefPubMedSearch in Google Scholar
  • 5 Heine M, van de Port I, Rietberg MB. et al. Exercise therapy for fatigue in multiple sclerosis. The Cochrane Database of Systematic Reviews 2015; 9: CD009956
    CrossrefPubMedSearch in Google Scholar
  • 6 Flachenecker P, Kümpfel T, Kallmann B. et al. Fatigue in multiple sclerosis: A comparison of different rating scales and correlation to clinical parameters. Multiple Sclerosis 2002; 8: 523-526
    CrossrefPubMedSearch in Google Scholar
  • 7 Flachenecker P, Meißner H. Fatigue bei Multipler Sklerose: Wie diagnostizieren, wie behandeln?. Neurol Rehabil 2014; 20: 273-281
    Search in Google Scholar
  • 8 Cruickshank TM, Reyes AR, Ziman MR. A systematic review and meta-analysis of strength training in individuals with multiple sclerosis or Parkinson disease. Medicine 2015; 94: e411
    CrossrefPubMedSearch in Google Scholar
  • 9 Latimer-Cheung AE, Pilutti LA, Hicks AL. et al. Effects of exercise training on fitness, mobility, fatigue, and health-related quality of life among adults with multiple sclerosis: A systematic review to inform guideline development. Archives of Physical Medicine and Rehabilitation 2013; 94: 1800-1828.e3
    CrossrefPubMedSearch in Google Scholar
  • 10 White LJ, McCoy SC, Castallano V. et al. Resistance training improves strength and functional capacity in persons with multiple sclerosis. Multiple Sclerosis 2004; 10: 668-674
    CrossrefPubMedSearch in Google Scholar
  • 11 Dodd KJ, Taylor NF, Shields N. et al. Progressive resistance training did not improve walking but can improve muscle performance, quality of life and fatigue in adults with multiple sclerosis: A randomized controlled trial. Multiple Sclerosis 2011; 17: 1362-1374
    CrossrefPubMedSearch in Google Scholar
  • 12 Dalgas U, Stenager E, Jakobsen J. et al. Fatigue, mood and quality of life improve in MS patients after progressive resistance training. Multiple Sclerosis 2010; 16: 480-490
    CrossrefPubMedSearch in Google Scholar
  • 13 Pilutti LA, Greenlee TA, Motl RW. et al. Effects of exercise training on fatigue in multiple sclerosis: A meta-analysis. Psychosomatic Medicine 2013; 75: 575-580
    CrossrefPubMedSearch in Google Scholar
  • 14 Gehlsen GM, Grigsby SA, Winant DM. Effects of an aquatic fitness program on the muscular strength and endurance of patients with multiple sclerosis. Physical Therapy 1984; 64: 653-657
    CrossrefPubMedSearch in Google Scholar
  • 15 Ferrauti A. Hrsg. Trainingswissenschat für die Sportpraxis: Ausdauertraining. Berlin: Springer; 2020: 345-404
    CrossrefSearch in Google Scholar
  • 16 Friedmann B. Neuere Entwicklungen im Krafttraining: Muskuläre Anpassungsreaktionen bei verschiedenen Krafttrainingsmethoden. Deutsche Zeitschrift für Sportmedizin 2007; 58: 12-18 68
    Search in Google Scholar
  • 17 Zaciorskij VM, Kraemer WJ. Krafttraining. Praxis und Wissenschaft. 4. Aufl. Aachen: Meyer & Meyer; 2016
    Search in Google Scholar
  • 18 Röwekamp A, Dargatz T. Aqua Fitness: Gelenkschonende Wassergymnastik für mehr Ausdauer, Beweglichkeit und Kraft. Über 85 Aqua-Fitness-Übungen mit Bildern & detaillierter Anleitung. 12 fertige Trainingspläne für jedes Level. 8th ed. Grünwald: Copress; 2017
    Search in Google Scholar
  • 19 Penner IK, Raselli C, Stöcklin M. et al. The Fatigue Scale for Motor and Cognitive Functions (FSMC): Validation of a new instrument to assess multiple sclerosis-related fatigue. Multiple Sclerosis 2009; 15: 1509-1517
    CrossrefPubMedSearch in Google Scholar
  • 20 Sehle A, Vieten M, Sailer S. et al. Objective assesment of motor fatigue in multiple sclerosis: The Fatigue index Kliniken Schmieder (FKS). Journal of Neurology 2014; 261: 1752-1762
    CrossrefPubMedSearch in Google Scholar
  • 21 Krupp LB, LaRocca NG, Muir-Nash J, Steinberg AD. The fatigue severity scale: Application to patients with multiple sclerosis and systemic lupus erythematosus. Archives of Neurology 1989; 46: 1121-1123
    CrossrefPubMedSearch in Google Scholar
  • 22 Flachenecker P, Müller G, König H. et al „Fatigue“ bei Multipler Sklerose: Entwicklung und Validierung des „Würzburger Erschöpfungsinventars bei MS“. Der Nervenarzt 2006; 77: 165-166 168–170, 172–174
    CrossrefPubMedSearch in Google Scholar
  • 23 Ritvo PG, Fischer JS, Miller DM. et al. MSQLI – Multiple Sclerosis Qualitiy of Life Inventory: A user’s manual. National Multiple Sclerosis Society. 1997 Im Internet: http://walkcoc.nationalmssociety.org/docs/HOM/MSQLI_Manual_and_Forms.pdf Stand: 20.03.2024
    PubMedSearch in Google Scholar
  • 24 Hobart J, Lamping D, Fitzpatrick R. et al. The Multiple Sclerosis Impact Scale (MSIS-29): A new patient-based outcome measure. Brain 2001; 124: 962-973
    CrossrefPubMedSearch in Google Scholar
  • 25 Bullinger M. Erfassung der gesundheitsbezogenen Lebensqualität mit dem SF-36-Health Survey. Bundesgesundheitsblatt – Gesundheitsforschung – Gesundheitsschutz 2000; 43: 190-197
    CrossrefSearch in Google Scholar
  • 26 Ahmadi A, Arastoo AA, Nikbakht M. et al. Comparison of the effect of 8 weeks aerobic and yoga training on ambulatory function, fatigue and mood status in MS patients. Iranian Red Crescent Medical Journal 2013; 15: 449-454
    CrossrefPubMedSearch in Google Scholar
  • 27 Bansi J, Bloch W, Gamper U. et al. Endurance training in MS: short-term immune responses and their relation to cardiorespiratory fitness, health-related quality of life, and fatigue. Journal of Neurology 2013; 260: 2993-3001
    CrossrefPubMedSearch in Google Scholar
  • 28 Dettmers C, Sulzmann M, Ruchay-Plössl A. et al. Endurance exercise improves walking distance in MS patients with fatigue. Acta neurologica Scandinavica 2009; 120: 251-257
    CrossrefPubMedSearch in Google Scholar
  • 29 Feys P, Moumdjian L, van Halewyck F. et al. Effects of an individual 12-week community-located “start-to-run” program on physical capacity, walking, fatigue, cognitive function, brain volumes, and structures in persons with multiple sclerosis. Multiple Sclerosis 2019; 25: 92-103
    CrossrefPubMedSearch in Google Scholar
  • 30 Heine M, Verschuren O, Hoogervorst EL. et al. Does aerobic training alleviate fatigue and improve societal participation in patients with multiple sclerosis? A randomized controlled trial. Multiple Sclerosis 2017; 23: 1517-1526
    CrossrefPubMedSearch in Google Scholar
  • 31 Langeskov-Christensen M, Hvid LG, Jensen HB. et al. Efficacy 70 of high-intensity aerobic exercise on common multiple sclerosis symptoms. Acta Neurologica Scandinavica 2021; 145: 229-238
    CrossrefPubMedSearch in Google Scholar
  • 32 Mokhtarzade M, Ranjbar R, Majdinasab N. et al. Effect of aerobic interval training on serum IL-10, TNFα, and adipokines levels in women with multiple sclerosis: Possible relations with fatigue and quality of life. Endocrine 2017; 57: 262-271
    CrossrefPubMedSearch in Google Scholar
  • 33 Mostert S, Kesselring J. Effects of a short-term exercise training program on aerobic fitness, fatigue, health perception and activity level of subjects with multiple sclerosis. Multiple Sclerosis 2002; 8: 161-168
    CrossrefPubMedSearch in Google Scholar
  • 34 Negaresh R, Motl R, Mokhtarzade M. et al Effect of short-term interval exercise training on fatigue, depression, and fitness in normal 71 weight vs. overweight person with multiple sclerosis. Explore 2019; 15 S. 134-141
    CrossrefPubMedSearch in Google Scholar
  • 35 Oken BS, Kishiyama S, Zajdel D. et al. Randomized controlled trial of yoga and exercise in multiple sclerosis. Neurology 2004; 62: 2058-2064
    CrossrefPubMedSearch in Google Scholar
  • 36 Petajan JH, Gappmaier E, White AT. et al. Impact of aerobic training on fitness and quality of life in multiple sclerosis. Annals of neurology 1996; 39: 432-441
    CrossrefPubMedSearch in Google Scholar
  • 37 Pilutti LA, Paulseth JE, Dove C. et al. Exercise training in progressive multiple sclerosis: A comparison of recumbent stepping and body weight-supported treadmill training. International Journal of MS Care 2016; 18: 221-229
    CrossrefPubMedSearch in Google Scholar
  • 38 Riemenschneider M, Hvid LG, Petersen T. et al. Exercise therapy in early multiple sclerosis improves physical function but not cognition: Secondary analyses from a randomized controlled trial. Neurorehabilitation and Neural Repair 2023; 37: 288-297
    CrossrefPubMedSearch in Google Scholar
  • 39 Sadeghi Bahmani D, Razazian N, Farnia V. et al. Compared to an active control condition, in persons with multiple sclerosis two different types of exercise training improved sleep and depression, but not fatigue, paresthesia, and intolerance of uncertainty. Multiple Sclerosis and related Disorders 2019; 36: 101356
    CrossrefPubMedSearch in Google Scholar
  • 40 Samaei A, Bakhtiary AH, Hajihasani A. et al. Uphill and downhill walking in multiple sclerosis: A randomized controlled trial. International Journal of MS Care 2016; 18: 34-41
    CrossrefPubMedSearch in Google Scholar
  • 41 Santoyo-Medina C, Janer Cabo M, Xaudaró DF. et al. Effect of nordic walking training on walking capacity and quality of life for people with multiple sclerosis. International Journal of MS Care 2023; 25: 118-123
    CrossrefPubMedSearch in Google Scholar
  • 42 Andreu-Caravaca L, Ramos-Campo D, Chung LH. et al. Effects of fast-velocity concentric resistance training in people with multiple sclerosis: A randomized controlled trial. In: Acta neurologica Scandinavica. 2022. 146. 652-661
    CrossrefSearch in Google Scholar
  • 43 Callesen J, Cattaneo D, Brincks J. et al. How do resistance training and balance and motor control training affect gait performance and fatigue impact in people with multiple sclerosis? A randomized controlled multi-center study. Multiple Sclerosis 2020; 26: 1420-1432
    CrossrefPubMedSearch in Google Scholar
  • 44 Dalgas U, Stenager E, Jakobsen J. et al. Fatigue, mood and quality of life improve in MS patients after progressive resistance training. Multiple Sclerosis 2010; 16: 480-490
    CrossrefPubMedSearch in Google Scholar
  • 45 Dodd KJ, Taylor NF, Shields N. et al. Progressive resistance training did not improve walking but can improve muscle performance, quality of life and fatigue in adults with multiple sclerosis: A randomized controlled trial. Multiple Sclerosis 2011; 17: 1362-1374
    CrossrefPubMedSearch in Google Scholar
  • 46 Englund S, Piehl F, Kierkegaard M. High-intensity resistance training in people with multiple sclerosis experiencing fatigue: A randomized controlled trial. Multiple Sclerosis and related Disorders 2022; 68: 104106
    CrossrefPubMedSearch in Google Scholar
  • 47 Manca A, Cabboi MP, Dragone D. et al. Resistance training for muscle weakness in multiple sclerosis: Direct versus contralateral approach in individuals with ankle dorsiflexors' disparity in strength. Archives of Physical Medicine and Rehabilitation 2017; 98: 1348-1356.e1
    CrossrefPubMedSearch in Google Scholar
  • 48 Canning KL, Hicks AL. Benefits of adhering to the Canadian physical activity guidelines for adults with multiple sclerosis beyond aerobic fitness and strength. International Journal of MS Care 2020; 22: 15-21
    CrossrefPubMedSearch in Google Scholar
  • 49 Correale L, Buzzachera CF, Liberali G. et al. Effects of combined endurance and resistance training in women with multiple sclerosis: A randomized controlled study. Front Neurol 2021; 12: 698460
    CrossrefPubMedSearch in Google Scholar
  • 50 Garrett M, Hogan N, Larkin A. et al. Exercise in the community for people with minimal gait impairment due to MS: An assessor-blind randomized controlled trial. Multiple Sclerosis 2013; 19: 782-789
    CrossrefPubMedSearch in Google Scholar
  • 51 Hayes HA, Gappmaier E, LaStayo PC. Effects of high-intensity resistance training on strength, mobility, balance, and fatigue in individuals with multiple sclerosis: A randomized controlled trial. Journal of neurologic physical therapy 2011; 35: 2-10
    CrossrefPubMedSearch in Google Scholar
  • 52 Kerling A, Keweloh K, Tegtbur U. et al. Effects of a short physical exercise intervention on patients with multiple sclerosis (MS). International Journal of Molecular Sciences 2015; 16: 15761-15775
    CrossrefPubMedSearch in Google Scholar
  • 53 Tallner A, Streber R, Hentschke C. et al. Internet-supported physical exercise training for persons with multiple sclerosis-A randomised, 74 controlled study. International Journal of Molecular Sciences 2016; 17
    CrossrefPubMedSearch in Google Scholar
  • 54 Bansi J, Bloch W, Gamper U, Kesselring J. Training in MS: Influence of two different endurance training protocols (aquatic versus overland) on cytokine and neurotrophin concentrations during three week randomized controlled trial. Multiple Sclerosis 2012; 19: 613-621
    CrossrefPubMedSearch in Google Scholar
  • 55 Castro-Sánchez AM, Matarán-Peñarrocha GA, Lara-Palomo I. et al Hydrotherapy for the treatment of pain in people with multiple sclerosis: A randomized controlled trial. Evidence-based Complementary and Alternative Medicine 2012; eCAM 473963
    CrossrefPubMedSearch in Google Scholar
  • 56 Kargarfard M, Etemadifar M, Baker P. et al. Effect of aquatic exercise training on fatigue and health-related quality of life in patients with multiple sclerosis. Archives of Physical Medicine and Rehabilitation 2012; 93: 1701-1708
    CrossrefPubMedSearch in Google Scholar
  • 57 Kooshiar H, Moshtagh M, Sardar MA. et al. Fatigue and quality of life of women with multiple sclerosis: A randomized controlled clinical trial. The Journal of Sports Medicine and Physical Fitness 2015; 55: 668-674
    PubMedSearch in Google Scholar
  • 58 Razazian N, Yavari Z, Farnia V. et al. Exercising Impacts on Fatigue, 72 Depression, and Paresthesia in Female Patients with Multiple Sclerosis. In: Medicine and Science in Sports and Exercise 2016; 48: 796-803
    CrossrefPubMedSearch in Google Scholar
  • 59 Surakka J, Romberg A, Ruutiainen J. et al. Effects of aerobic and strength exercise on motor fatigue in men and women with multiple sclerosis: A randomized controlled trial. Clinical Rehabilitation 2004; 18: 737-746
    CrossrefPubMedSearch in Google Scholar
  • 60 Ozsoy-Unubol T, Ata E, Cavlak M. et al. Effects of robot-assisted gait training in patients with multiple sclerosis: A single-blinded randomized controlled study. American Journal of Physical Medicine & Rehabilitation 2022; 101: 768-774
    CrossrefPubMedSearch in Google Scholar
  • 61 Straudi S, Fanciullacci C, Martinuzzi C. et al. The effects of robot-assisted gait training in progressive multiple sclerosis: A randomized controlled trial. Multiple Sclerosis 2015; 22: 373-384
    CrossrefPubMedSearch in Google Scholar
  • 62 Straudi S, Manfredini F, Lamberti N. et al. Robot-assisted gait training is not superior to intensive overground walking in multiple sclerosis with severe disability (the RAGTIME study): A randomized controlled trial. Multiple Sclerosis 2020; 26: 716-724
    CrossrefPubMedSearch in Google Scholar
  • 63 Torres-Costoso A, Martínez-Vizcaíno V, Reina-Gutiérrez S. et al. Effect of exercise on fatigue in multiple sclerosis: A network meta-analysis comparing different types of exercise. Archives of Physical Medicine and Rehabilitation 2022; 103: 970-987.e18
    CrossrefPubMedSearch in Google Scholar