لخّصلي

Receiving treatment was a significant predictor of
reduced symptom frequency (partial ? = .26) at the l-year
follow-up. The ES adjusted for baseline values indicated substantial reductions in symptom frequency for the treatment
group @%,atment = .27 vs ESwaiaist = -.32). Fatigue was significantly reduced at the time of follow-up for the treatment group
compared with the waiting list group (ES,,,,,, = .46 vs ESwaitist
= -.20). There were no statistically significant differences
among groups regarding functional status, but there appeared
to be less loss of functional status in the treatment group compared with the waiting list group (ES,,,,,, = -.07 vs ESwGdist
zz -.70).
Conclusi and Body temperature declined
during both high-dose and low-dose cooling, but high-dose produced a greater reduction (p 0.0001). High-dose cooling
produced a small improvement in the MSFC (0.076 0.66, p
0.007), whereas low-dose cooling produced only a trend
toward improvement (0.053 0.031, p
0.09), but the difference between conditions was not significant. Timed gait
testing and visual acuity/contrast sensitivity improved in both conditions as well and Analysis was by
intention-to-treat. A group by time interaction showed that the CBT group reported significantly greater reductions in fatigue across
the 8 months compared with the RT group (p
.02). Calculated effect sizes for fatigue from baseline to the end of treatment were
3.03 [95% confidence interval, 2.22–3.68] for the CBT group and 1.83 [95% confidence interval, 1.26 –2.34] for the RT group.
Results also indicted that both groups showed clinically significant decreases in fatigue defined as fatigue levels equivalent or less
than those reported by a nonfatigued healthy comparison group. There were no significant interactions between group and any of
the secondary outcome variables, with both groups showing improvements over time on all measures and We found 45 trials, involving 2250 people with MS, assessing the eDect of exercise therapy using self reported fatigue. We used 36 studies, involving 1603 people with MS, in an analysis. Combined, these 36 trials supported the idea that exercise therapy may be a promising treatment to reduce fatigue without side events. This finding seems especially true for endurance training, mixed training (i.e. muscle power training mixed with endurance training), or 'other' training (e.g. yoga, tai-chi). To assess the safety of exercise therapy we counted the number of reported MS relapses in the people receiving exercise therapy and in people in a non-exercise group and did not find a significant diDerence and The electronic database search retrieved 1883 published articles on fatigue in MS (1061), stroke (474), TBI (113), and PD (235). Of these, 462 articles met title inclusion criteria of which 89 articles met the abstract inclusion criteria and went on to full-text review. Four articles that met the abstract inclusion criteria were identified from the cross referencing and bibliographies of relevant articles. Overall, 56 studies (22 systematic reviews/meta analyses, 32 RCTs, 2 CCT) fulfilled the inclusion criteria for this review. Of these, majority 35 studies evaluated different rehabilitation interventions in MS, 6 in stroke, 10 in TBI, 2 in PD, and 3 in mixed neurological conditions. and Results it presents various findings and insights throughout the document related to the relationship between fatigue and cognitive function, motor function, pathogenic mechanisms, treatment approaches, and the need for further research in understanding and managing fatigue in multiple sclerosis (MS) , , . These results collectively contribute to the overall understanding of the impact of fatigue on individuals with MS and the ongoing efforts to address this significant symptom and Fatigue, functional capacity, and fitness were significantly better after exercise than after flexibility treatment. 12 of 22 patients who crossed over to exercise after flexibility treatment rated themselves as better after completing exercise treatment. 32 of 47 patients rated themselves as better three months after completing supervised exercise treatment. 35 of 47 patients rated themselves as better one year after completing supervised exercise treatment and Improvement at 3-month follow-up assessment of motor symptoms (p