title: Effects of multidisciplinary rehabilitation on chronic fatigue in multiple sclerosis: a randomized controlled trial.
abstract: BACKGROUND
  Several rehabilitation programmes aim at reducing the impact of fatigue in MS patients. Acute and chronic fatigue should require different management.
  
  
  OBJECTIVE
  To assess the effects of individually tailored, multidisciplinary outpatient rehabilitation (MDR) on chronic fatigue.
  
  
  METHODS
  Forty-eight ambulatory MS patients with chronic fatigue were randomized to MDR or to MS-nurse consultation. Fatigue was assessed by the Checklist Individual Strength (CIS-20R). Secondary outcomes included the Modified Fatigue Impact Scale, Fatigue Severity Scale, Functional Independence Measure, Disability and Impact Profile (DIP), Multiple Sclerosis Impact Scale and the Impact on Participation and Autonomy (IPA).
  
  
  RESULTS
  The primary outcome measure CIS-20R overall score showed no significant differences between groups at 12 weeks (P = 0.39) and 24 weeks follow-up (P = 0.14), nor for subscales (t = 12 and t = 24, 0.19≤P≤0.88). No significant within-group effects were found for both groups with respect to the primary (0.57≤p≤0.97) and secondary (0.11≤p≤0.92) outcome measures from baseline to 12 or 24 weeks.
  
  
  CONCLUSIONS
  Multidisciplinary rehabilitation was not more effective in terms of reducing self-reported fatigue in MS patients compared to MS-nurse consultation. Our results suggest that chronic fatigue in patients with MS may be highly invariant over time, irrespective of interventions.
  
  
  BACKGROUND
  controlled-trials.com ISRCTN05017507.
authors.affiliation: Department of Rehabilitation Medicine, MOVE Research Institute Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Marc B
authors.initials: MB
authors.lastname: Rietberg
authors.affiliation: Department of Rehabilitation Medicine, MOVE Research Institute Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Erwin E H
authors.initials: EE
authors.lastname: van Wegen
authors.affiliation: Department of Rehabilitation Medicine, MOVE Research Institute Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Isaline C J M
authors.initials: IC
authors.lastname: Eyssen
authors.affiliation: Department of Rehabilitation Medicine, MOVE Research Institute Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Gert
authors.initials: G
authors.lastname: Kwakkel
mesh_terms: D002908:Chronic Disease; D003253:Consultants; D005221:Fatigue / Q000150:complications / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications / Q000503:physiopathology / Q000534:rehabilitation*; D009726:Nurses; D009788:Occupational Therapy; D026741:Physical Therapy Modalities; D016896:Treatment Outcome