Fighting fatigue
Researchers are studying various treatments and ways to manage this common MS symptom. by Brandie Jefferson
Fatigue is one of the most common symptoms of multiple sclerosis, and it’s a prominent focus of a variety of research studies aimed at treatment and management, as well.
Fatigue can be a primary or secondary symptom — either caused by the disease directly or the result of other symptoms, such as spasms — leading to people tiring more easily from minimal physical activity. There are a variety of ways to try to manage fatigue, although no medication has been approved by the U.S. Food and Drug Administration (FDA) to treat MS fatigue, specifically. “There is a major unmet need for treatment options,” says Leigh Charvet, MD, professor of neurology at the New York University Grossman School of Medicine. Bringing the fatigue fight home Nora Fritz, PhD, associate professor of healthcare sciences, physical therapy and neurology at Wayne State University in Detroit, is researching causes of and solutions to fatigue and fatigability in the home. Most people with MS have an all-too-familiar understanding of fatigue. But what about fatigability?
accelerometers, (devices that captured their motion every 15 seconds). They were also asked to report their level of fatigue four times throughout the day. That’s 28 self-reported measures of fatigue instead of the one captured by a traditional survey measure of fatigue. The researchers will analyze the data to understand how different activities and intensities relate to fatigue. If a person reports a lot of fatigue after going for a long walk, “we can look at the effects of that activity on fatigue,” Fritz says, breaking it down into intricate details to truly capture how that walk affected the rest of the participant’s day.
over the phone, using online video conferencing or using an asynchronous internet platform. Regardless of the format, they’ll all be learning the same lessons about ways to self-manage their fatigue and reduce its impact. For example, “The first topic is all about resting,” Plow says. “How to rest. When to rest. Experimenting with rest. What kind of rest is best?” For one person, it might be meditation. For another, it might be bobbing their head to their favorite music. Participants were asked which intervention they’d prefer ahead of time, then randomly assigned to a group. When it comes to which method is most successful for any individual, “I think preference will be a very strong predictor,” he says. That is, he thinks people will see better results if they are in the group that they wanted to be in. Once the results have been analyzed, Plow hopes to be able to understand which intervention will work best for any individual. Is it a one-to-one format or a group format? Or maybe a person would be more successful checking in on an internet platform weekly, whenever their schedule allows. That’s the beauty of working with an occupational therapist. “They help people figure out the trial-and-error process,” Plow says. “It’s empowering people to do their own experiments and figure out what works for them.”
someone’s fatigue. Maybe tDCS was activating on its own. Or maybe it worked by improving mood, or something else.”
Charvet began to hear from her patients in her early studies that the use of tDCS has lessened their fatigue and found tDCS to have a significant benefit in her 2016 study. “We don’t know that it’s targeting the source of fatigue, but people were definitely reporting less fatigue when they were doing it.”
It’s been so successful that, thanks to patient lobbying, Charvet is now able to offer a tDCS clinical service through NYU Langone Health’s innovative care guidance that offers home-based access via telehealth. Ultimately, she wants to see tDCS approved by the FDA for medical use, which would provide more clinical access. When that day comes, Charvet will be ready, thanks in large part to the participants who allowed her team to come into their homes so that they could design a technology together that would work for a wide spectrum of people.
“This is all driven by people living with MS. I don’t want to study something that people don’t want to do or won’t use,” Charvet says. “All I want is more tools to allow for people to have a better quality of life.”
https://momentummagazineonline.com/fighting-fatigue/
Researchers are studying various treatments and ways to manage this common MS symptom. by Brandie Jefferson
Fatigue is one of the most common symptoms of multiple sclerosis, and it’s a prominent focus of a variety of research studies aimed at treatment and management, as well.
Fatigue can be a primary or secondary symptom — either caused by the disease directly or the result of other symptoms, such as spasms — leading to people tiring more easily from minimal physical activity. There are a variety of ways to try to manage fatigue, although no medication has been approved by the U.S. Food and Drug Administration (FDA) to treat MS fatigue, specifically. “There is a major unmet need for treatment options,” says Leigh Charvet, MD, professor of neurology at the New York University Grossman School of Medicine. Bringing the fatigue fight home Nora Fritz, PhD, associate professor of healthcare sciences, physical therapy and neurology at Wayne State University in Detroit, is researching causes of and solutions to fatigue and fatigability in the home. Most people with MS have an all-too-familiar understanding of fatigue. But what about fatigability?
accelerometers, (devices that captured their motion every 15 seconds). They were also asked to report their level of fatigue four times throughout the day. That’s 28 self-reported measures of fatigue instead of the one captured by a traditional survey measure of fatigue. The researchers will analyze the data to understand how different activities and intensities relate to fatigue. If a person reports a lot of fatigue after going for a long walk, “we can look at the effects of that activity on fatigue,” Fritz says, breaking it down into intricate details to truly capture how that walk affected the rest of the participant’s day.
over the phone, using online video conferencing or using an asynchronous internet platform. Regardless of the format, they’ll all be learning the same lessons about ways to self-manage their fatigue and reduce its impact. For example, “The first topic is all about resting,” Plow says. “How to rest. When to rest. Experimenting with rest. What kind of rest is best?” For one person, it might be meditation. For another, it might be bobbing their head to their favorite music. Participants were asked which intervention they’d prefer ahead of time, then randomly assigned to a group. When it comes to which method is most successful for any individual, “I think preference will be a very strong predictor,” he says. That is, he thinks people will see better results if they are in the group that they wanted to be in. Once the results have been analyzed, Plow hopes to be able to understand which intervention will work best for any individual. Is it a one-to-one format or a group format? Or maybe a person would be more successful checking in on an internet platform weekly, whenever their schedule allows. That’s the beauty of working with an occupational therapist. “They help people figure out the trial-and-error process,” Plow says. “It’s empowering people to do their own experiments and figure out what works for them.”
someone’s fatigue. Maybe tDCS was activating on its own. Or maybe it worked by improving mood, or something else.”
Charvet began to hear from her patients in her early studies that the use of tDCS has lessened their fatigue and found tDCS to have a significant benefit in her 2016 study. “We don’t know that it’s targeting the source of fatigue, but people were definitely reporting less fatigue when they were doing it.”
It’s been so successful that, thanks to patient lobbying, Charvet is now able to offer a tDCS clinical service through NYU Langone Health’s innovative care guidance that offers home-based access via telehealth. Ultimately, she wants to see tDCS approved by the FDA for medical use, which would provide more clinical access. When that day comes, Charvet will be ready, thanks in large part to the participants who allowed her team to come into their homes so that they could design a technology together that would work for a wide spectrum of people.
“This is all driven by people living with MS. I don’t want to study something that people don’t want to do or won’t use,” Charvet says. “All I want is more tools to allow for people to have a better quality of life.”
https://momentummagazineonline.com/fighting-fatigue/
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