title: Effect of aquatic exercise training on fatigue and health-related quality of life in patients with multiple sclerosis.
abstract: OBJECTIVE
  To examine the effectiveness of aquatic exercise training on fatigue and health-related quality of life (HRQOL) in women with multiple sclerosis (MS).
  
  
  METHODS
  Randomized controlled trial, 4-week and 8-week follow-up.
  
  
  METHODS
  Referral center of a multiple sclerosis society.
  
  
  METHODS
  Women (N=32) diagnosed with relapsing-remitting MS (mean age ± SD, 32.6±8.0y) were recruited into this study. After undergoing baseline testing by a neurologist, participants were randomly assigned to either an intervention (aquatic exercise) or a control group.
  
  
  METHODS
  The intervention consisted of 8 weeks supervised aquatic exercise in a swimming pool (3 times a week, each session lasting 60min).
  
  
  METHODS
  At baseline, 4 weeks, and 8 weeks, fatigue and HRQOL were assessed by a blind assessor using the Modified Fatigue Impact Scale and the Multiple Sclerosis Quality of Life-54 questionnaire, respectively. A mixed-model approach to repeated-measures analysis of variance was used to detect within- and between-subject effects.
  
  
  RESULTS
  Findings are based on 21 patients (10 from the exercise group and 11 from the control group) who had data available on outcomes. There was no significant difference between the 2 groups at the baseline. Patients in the aquatic exercise group showed significant improvements in fatigue and subscores of HRQOL after 4 and 8 weeks compared with the control group. Results obtained from the intention-to-treat analysis were consistent with those of per-protocol analysis.
  
  
  CONCLUSIONS
  The findings suggest that aquatic exercise training can effectively improve fatigue and HRQOL of patients with MS and should be considered in the management of this relatively common public health problem.
authors.affiliation: Faculty of Physical Education and Sport Sciences, University of Isfahan, Isfahan, Iran.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Kargarfard
authors.forename: Masoud
authors.initials: M
authors.lastname: Etemadifar
authors.forename: Peter
authors.initials: P
authors.lastname: Baker
authors.forename: Maryam
authors.initials: M
authors.lastname: Mehrabi
authors.forename: Reza
authors.initials: R
authors.lastname: Hayatbakhsh
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D004185:Disability Evaluation; D005081:Exercise Therapy / Q000379:methods*; D005221:Fatigue / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D006875:Hydrotherapy / Q000379:methods*; D009103:Multiple Sclerosis / Q000534:rehabilitation*; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome