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Comparing two relaxation procedures to ease fatigue in multiple sclerosis: a single-blind randomized controlled

Guadalupe Garis1,2, Christian Dettmers3, Andrea Hildebrandt4

  • 1Department of Psychology, Carl Von Ossietzky University Oldenburg, Oldenburg, Germany. g.garis1992@gmail.com.

Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
|September 12, 2023
PubMed
Summary

Progressive muscle relaxation (PMR) significantly reduced fatigue in multiple sclerosis (MS) patients. Deep breathing (DB) and PMR altered autonomic nervous system (ANS) activity, but only PMR alleviated fatigue.

Keywords:
Autonomic nervous systemBiofeedbackFatigueHeart rate variabilityMultiple sclerosisProgressive muscle relaxation

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Area of Science:

  • Neurology
  • Rehabilitation Medicine
  • Psychophysiology

Background:

  • Fatigue is a common and debilitating symptom in multiple sclerosis (MS).
  • Various relaxation techniques exist, but their comparative efficacy for MS fatigue and autonomic nervous system (ANS) activity is unclear.
  • Biofeedback-supported relaxation exercises, specifically deep breathing (DB) and progressive muscle relaxation (PMR), were investigated.

Purpose of the Study:

  • To compare the effects of DB and PMR on fatigue reduction in MS patients.
  • To assess the impact of these relaxation techniques on ANS activity.
  • To evaluate the utility of a fatigue-inducing vigilance task combined with heart rate variability (HRV) measurements.

Main Methods:

  • A single-blind randomized clinical trial involving 34 MS patients.
  • Assessment of cardiovagal integrity using HRV response to DB.
  • Administration of a vigilance task followed by either DB or PMR, with fatigue and HRV measurements at baseline, post-task, and post-intervention.

Main Results:

  • Only PMR led to a significant reduction in short-term fatigue.
  • Both DB and PMR influenced ANS activity.
  • The vigilance task increased fatigue and decreased parasympathetic HRV; trait fatigue correlated negatively with HRV.

Conclusions:

  • PMR is effective in alleviating short-term fatigue in individuals with MS.
  • The vigilance task and HRV measurement paradigm can aid in evaluating fatigue-reduction interventions.
  • Future research should explore longer, more frequent relaxation sessions, particularly for individuals with mild to moderate fatigue.