Comparing two relaxation procedures to ease fatigue in multiple sclerosis: a single-blind randomized controlled trial.
Autonomic nervous system
Biofeedback
Fatigue
Heart rate variability
Multiple sclerosis
Progressive muscle relaxation
Journal
Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
ISSN: 1590-3478
Titre abrégé: Neurol Sci
Pays: Italy
ID NLM: 100959175
Informations de publication
Date de publication:
Nov 2023
Nov 2023
Historique:
received:
10
03
2023
accepted:
16
08
2023
pubmed:
12
9
2023
medline:
12
9
2023
entrez:
12
9
2023
Statut:
ppublish
Résumé
Various relaxation procedures have been proposed to reduce fatigue in multiple sclerosis (MS). However, it is unknown, which type of relaxation has the largest effect on fatigue reduction and on autonomic nervous system (ANS) activity. We aimed to compare two biofeedback-supported relaxation exercises: a deep breathing (DB) exercise and progressive muscle relaxation (PMR), which may ameliorate MS fatigue and alter ANS activity. We performed a single-blind randomized clinical trial, introducing MS patients (n = 34) to the DB or PMR exercise. We first tested cardiovagal integrity, reflected by changes in heart rate variability (HRV) in response to DB. Participants then performed a fatigue-inducing vigilance task, followed by the DB or PMR. State fatigue was recorded consecutively at baseline, after the vigilance task, and after the relaxation exercise, along with HRV reflecting ANS activity. Only patients assigned to the PMR group experienced a significant drop in fatigue, whereas both relaxation exercises changed ANS activity. MS patients showed the expected autonomic response during the cardiovagal reflex test. The vigilance task elevated short-term feelings of fatigue and significantly reduced HRV parameters of parasympathetic activity. Trait fatigue was negatively correlated with HRV during the second half of the vigilance task. PMR alleviates short-term feelings of fatigue in persons with MS. The vigilance task in combination with HRV measurements may be helpful for evaluating relaxation procedures as a treatment of fatigue. Hereby, future studies should ensure longer and more frequent relaxation exercises and focus on patients with weak to moderate fatigue. Trial Registry: DRKS00024358.
Sections du résumé
BACKGROUND
BACKGROUND
Various relaxation procedures have been proposed to reduce fatigue in multiple sclerosis (MS). However, it is unknown, which type of relaxation has the largest effect on fatigue reduction and on autonomic nervous system (ANS) activity.
OBJECTIVE
OBJECTIVE
We aimed to compare two biofeedback-supported relaxation exercises: a deep breathing (DB) exercise and progressive muscle relaxation (PMR), which may ameliorate MS fatigue and alter ANS activity.
METHODS
METHODS
We performed a single-blind randomized clinical trial, introducing MS patients (n = 34) to the DB or PMR exercise. We first tested cardiovagal integrity, reflected by changes in heart rate variability (HRV) in response to DB. Participants then performed a fatigue-inducing vigilance task, followed by the DB or PMR. State fatigue was recorded consecutively at baseline, after the vigilance task, and after the relaxation exercise, along with HRV reflecting ANS activity.
RESULTS
RESULTS
Only patients assigned to the PMR group experienced a significant drop in fatigue, whereas both relaxation exercises changed ANS activity. MS patients showed the expected autonomic response during the cardiovagal reflex test. The vigilance task elevated short-term feelings of fatigue and significantly reduced HRV parameters of parasympathetic activity. Trait fatigue was negatively correlated with HRV during the second half of the vigilance task.
CONCLUSION
CONCLUSIONS
PMR alleviates short-term feelings of fatigue in persons with MS. The vigilance task in combination with HRV measurements may be helpful for evaluating relaxation procedures as a treatment of fatigue. Hereby, future studies should ensure longer and more frequent relaxation exercises and focus on patients with weak to moderate fatigue.
TRIAL REGISTRATION
BACKGROUND
Trial Registry: DRKS00024358.
Identifiants
pubmed: 37698785
doi: 10.1007/s10072-023-07042-x
pii: 10.1007/s10072-023-07042-x
pmc: PMC10570225
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
4087-4098Informations de copyright
© 2023. The Author(s).
Références
Mult Scler. 2015 Apr;21(4):376-81
pubmed: 25257615
Neurology. 2003 Sep 23;61(6):851-3
pubmed: 14504339
Nervenarzt. 2018 Apr;89(4):446-452
pubmed: 29079869
Sleep Med Rev. 2017 Apr;32:95-108
pubmed: 27107751
J Neurol. 2001 Mar;248(3):174-9
pubmed: 11355149
Front Neurol. 2014 Sep 15;5:177
pubmed: 25309504
J Altern Complement Med. 2012 Oct;18(10):983-7
pubmed: 22967281
J Clin Nurs. 2009 Aug;18(15):2171-9
pubmed: 19583649
Arch Phys Med Rehabil. 1984 Mar;65(3):135-8
pubmed: 6703889
J Rheumatol. 2004 Oct;31(10):1896-902
pubmed: 15468350
J Neurosci Nurs. 2022 Apr 1;54(2):86-91
pubmed: 35149625
Int J Psychophysiol. 2014 Mar;91(3):206-11
pubmed: 24380741
Front Neurol. 2014 Dec 11;5:264
pubmed: 25566171
Curr Treat Options Neurol. 2016 Jun;18(6):26
pubmed: 27087457
J Psychosom Res. 2005 Dec;59(6):393-8
pubmed: 16310021
Mult Scler. 2009 Dec;15(12):1509-17
pubmed: 19995840
Psychiatry Res. 1989 May;28(2):193-213
pubmed: 2748771
Neuropsychol Rehabil. 2022 Jan;32(1):131-147
pubmed: 32851896
Med Sci Sports Exerc. 2016 May;48(5):796-803
pubmed: 26656775
Neurology. 2004 Jun 8;62(11):2058-64
pubmed: 15184614
Ment Health Fam Med. 2010 Jun;7(2):85-91
pubmed: 22477926
Mult Scler Int. 2014;2014:109142
pubmed: 24575302
Ann Neurol. 2011 Feb;69(2):292-302
pubmed: 21387374
Mult Scler. 2001 Jun;7(3):201-6
pubmed: 11475445
Neurol Sci. 2023 Jan;44(1):83-98
pubmed: 36125573
Annu Int Conf IEEE Eng Med Biol Soc. 2007;2007:4656-9
pubmed: 18003044
Neurology. 1983 Nov;33(11):1444-52
pubmed: 6685237
Mult Scler. 1999 Aug;5(4):244-50
pubmed: 10467383
Psychophysiology. 1994 May;31(3):223-8
pubmed: 8008785
Sleep. 2010 Aug;33(8):1061-7
pubmed: 20815187
Lancet Neurol. 2021 Jan;20(1):38-48
pubmed: 33242419
Appl Psychophysiol Biofeedback. 2002 Mar;27(1):45-98
pubmed: 12001885
Telemed J E Health. 2015 May;21(5):404-14
pubmed: 25807067
Brain Inj. 2021 Aug 24;35(10):1254-1258
pubmed: 34487467
Brain Res. 2014 May 2;1561:60-6
pubmed: 24642273
Mult Scler Relat Disord. 2019 Jul;32:13-18
pubmed: 31005825
Front Public Health. 2017 Sep 28;5:258
pubmed: 29034226
Mult Scler J Exp Transl Clin. 2017 Apr 05;3(2):2055217317701317
pubmed: 28607756
Iran J Nurs Midwifery Res. 2015 Mar-Apr;20(2):200-4
pubmed: 25878696
Complement Ther Clin Pract. 2018 May;31:64-70
pubmed: 29705482
J Caring Sci. 2016 Dec 01;5(4):325-335
pubmed: 28032077
Complement Ther Clin Pract. 2015 Nov;21(4):277-81
pubmed: 26573455
Cochrane Database Syst Rev. 2015 Sep 11;(9):CD009956
pubmed: 26358158
Front Psychol. 2014 Jul 21;5:756
pubmed: 25101026
Clin Neurophysiol. 2018 Aug;129(8):1588-1594
pubmed: 29885648
Mult Scler. 2013 May;19(6):782-9
pubmed: 23128667
Brain Sci. 2019 May 02;9(5):
pubmed: 31052593
J Clin Med. 2020 Sep 30;9(10):
pubmed: 33008032
Can J Neurol Sci. 1994 Feb;21(1):9-14
pubmed: 8180914
J Am Coll Cardiol. 1998 Mar 1;31(3):593-601
pubmed: 9502641
Hypertension. 2010 Apr;55(4):1033-9
pubmed: 20194302