Friday, 25 November 2011

Motor imagery as a treatment for fatigue

Catalan et al. Treatment of Fatigue in Multiple Sclerosis Patients: A Neurocognitive Approach. Rehabil Res Pract. 2011;2011:670537. Epub 2011 Sep 8.

The objective of the study was to treat fatigue in MS'ers by a neurocognitive rehabilitation program aimed at improving motor planning by using motor imagery (MI). 20 MS'ers complaining of fatigue were treated for 5 weeks with exercises of neurocognitive rehabilitation twice a week. MS'ers were evaluated by Fatigue Severity Scale (FSS), Modified Fatigue Impact Scale (MFIS), MSQoL54, Expanded Disability Status Scale (EDSS), and MS Functional Composite (MSFC). 


After treatment, a decrease in fatigue was detected with both FSS (P = 0.0001) and MFIS (P = 0.0001). MSFC (P = 0.035) and MSQoL54 (P = 0.002) scores improved compared to baseline. At six-month followup, the improvement was confirmed for fatigue (FSS, P = 0.0001; MFIS P = 0.01) and for the physical subscale of MSQoL54 (P = 0.049). No differences in disability scales were found. These results show that neurocognitive rehabilitation, based on MI, could be a strategy to treat fatigue in MS patients.

"This study is too small to draw any conclusions, but it does suggest that fatigue may respond to some interventions. I don't have any experience with motor imagery. Do any of you?"

"This study will need to be reproduced; it is too small."

8 comments:

  1. This comment has been removed by a blog administrator.

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  2. I recently suggested to a friend with MS, that maybe for her fatigue that she try hypnosis to help her to strengthen her core. Hypnosis will only work with someone who wants the therapy to work, so therefore this suggestion might have validity even if only a neural-placebo fix...

    And if it works for that, why not try hypnosis for those whose legs no longer work like they once had...

    What have you got to say of this suggestion?

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  3. It would be brilliant if it helped!

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  4. Re: "What have you got to say of this suggestion?"

    Good ideas need to be backed-up with solutions. How do you anticipate doing a trial to test this hypothesis? It will be difficult doing a randomised double-blind placebo controlled trial. May be you should review the hypnosis literature and come back to use with an outline for a study.

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  5. I am delighted to see that you are intrigued my my thought on this hypnosis therapy.

    We should take this to another step, but where would we get funding to do this study?

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  6. Re: "We should take this to another step, but where would we get funding to do this study?"

    I am not sure; I would need to see a compelling trial design. I am not sure you could do a proper blinded study of hypnosis. But I am prepared to be convinced otherwise.

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  7. Motor imagery is quite a big research area in psychology / neuroscience. It's used a lot in sports. Top line is that imagining actions largely activates the same neural substrates as the actions themselves. I remember reading (a while ago) various studies demonstrating that imagining exercise can actually increase muscle mass & strength; not as much as actually doing the exercise, but significantly more than doing nothing. Mental sit ups & push ups whenever meetings get boring? This study may be small, but the findings fit well with what is known to sports psychologists and trainers.

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  8. This concept intrigues me. There are some studies for ME (aka Chronic Fatigue) that suggest that the 'central governor' theory plays a role and I've been looking to see if anything similar has been done in the MS space when it comes to fatigue. In a middle of a relapse it makes sense to me that my fatigue is bad but I'd like to know why it doesn't recover to anywhere near normal when the rest of my symptoms subside. I'm thinking I'll do a highly unscientific experiment of n=1 since the risk nil. The problem with this whole area of research is that it does not lend itself well to double blinded trials. That does not mean there isn't validity to it.

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