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  • 1
    Online Resource
    Online Resource
    Multidisciplinary fatigue management programme in multiple sclerosis: a randomized clinical trial
    SAGE Publications ; 2007
    In:  Multiple Sclerosis Journal Vol. 13, No. 8 ( 2007-09), p. 996-1003
    Details
    In: Multiple Sclerosis Journal, SAGE Publications, Vol. 13, No. 8 ( 2007-09), p. 996-1003
    Abstract: Objective To establish the efficacy of a multidisciplinary fatigue management programme (MFMP) in MS. Method Fifty-one subjects with MS were randomly allocated to group A, who only received the four weeks MFMP, or group B receiving a placebo intervention programme first and the MFMP after 6 months. In both groups, assessment was performed at baseline, 3 weeks and 6 months after the programmes and included Modified Fatigue Impact Scale (MFIS), Fatigue Severity Scale (FSS), MS Self-Efficacy scale (MSSE), Mental Health Inventory (MHI) and Impact on Participation and Autonomy (IPA). Results The MFIS showed a significant change over time ( F(4,152) = 3.346, P = 0.012), which was similar in both groups (time*group interaction: F(4,152) = 1.094, P = 0.361). A clinically relevant reduction of MFIS score of 10 points or more was found in 17% of individuals following the MFMP, compared to 44% after the placebo intervention programme ( P = 0.06). Compared to no intervention, a significant effect of the MFMP after 6 months ( P = 0.003) was found in five participants (31%). No significant changes in FSS, MSSE, MHI and IPA, in both groups, were found. Conclusion Although an additional effect was found, the multidisciplinary fatigue management programme showed no efficacy in reducing the impact of fatigue compared to a placebo intervention programme. Multiple Sclerosis 2007; 13: 996—1003. http://msj.sagepub.com
    Type of Medium: Online Resource
    ISSN: 1352-4585 , 1477-0970
    URL: Article
    DOI: 10.1177/1352458507078392
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2007
    detail.hit.zdb_id: 2008225-3
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  • 2
    Online Resource
    Online Resource
    Electronic visual analogue scales for pain, fatigue, anxiety and quality of life in people with multiple sclerosis using smartphone and tablet: a reliability and feasibility study
    SAGE Publications ; 2017
    In:  Clinical Rehabilitation Vol. 31, No. 9 ( 2017-09), p. 1215-1225
    Details
    In: Clinical Rehabilitation, SAGE Publications, Vol. 31, No. 9 ( 2017-09), p. 1215-1225
    Abstract: To explore the reliability and feasibility of electronic visual analogue scales in people with multiple sclerosis (MS) and healthy individuals. Design: Cross-sectional observational study Setting: Clinical setting Subjects: Convenience sample of 52 people with MS and 52 matched healthy controls Interventions: NA Main measures: Participants scored 15 statements assessing fatigue, pain, anxiety and quality of life on an electronic visual analogue scale (eVAS), either using a smartphone or a tablet (randomly allocated). To check for test-retest reliability, statements were administered in two separate randomly ordered groups. Subjects completed a feasibility questionnaire. Results: Mean (SD) eVAS scores ranged from 35 (28.1) to 80 (22.1) in MS group, and from 57 (28.0) to 86 (13.2) in controls. Intra Class Correlations ranged from 0.73 to 0.95 in MS sample; 0.61 to 0.92 in controls. For most statements, Bland-Altman plots indicated no systematic error, but relatively large random error of the eVAS scores (exceeding 20mm). Considerable ceiling effects (i.e. better health) were found in healthy controls. Similar reliability was found among smartphone or tablet, different demographic groups and the experience-groups. Conclusion: Electronic visual analogue scales are reliable and useful for people with MS to register fatigue, pain, anxiety and quality of life.
    Type of Medium: Online Resource
    ISSN: 0269-2155 , 1477-0873
    URL: Article
    DOI: 10.1177/0269215517692641
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2017
    detail.hit.zdb_id: 2028323-4
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  • 3
    Online Resource
    Online Resource
    Sunlight exposure and sun sensitivity associated with disability progression in multiple sclerosis
    SAGE Publications ; 2012
    In:  Multiple Sclerosis Journal Vol. 18, No. 4 ( 2012-04), p. 451-459
    Details
    In: Multiple Sclerosis Journal, SAGE Publications, Vol. 18, No. 4 ( 2012-04), p. 451-459
    Abstract: Background: Sunlight and vitamin D have been inversely associated with the risk of multiple sclerosis (MS). Objective: We investigated sunlight exposure and sun sensitivity in relation to disability progression in MS. Methods: We conducted a survey among persons with MS, registered by the Flemish MS society, Belgium, and stratified data according to relapsing-onset and progressive-onset MS. We used Kaplan–Meier survival and Cox proportional hazard regression analyses with time to Expanded Disability Status Scale (EDSS) 6 as outcome measure. Hazard ratios for the time from onset and from birth were calculated for the potentially predictive variables, adjusting for age at onset, gender and immunomodulatory treatment. Results: 704 (51.3%) of the 1372 respondents had reached EDSS 6. In relapsing-onset MS, respondents reporting equal or higher levels of sun exposure than persons of the same age in the last 10 years had a decreased risk of reaching EDSS 6. In progressive-onset MS, increased sun sensitivity was associated with an increased hazard of reaching EDSS 6. Conclusion: The association of higher sun exposure with a better outcome in relapsing-onset MS may be explained by either a protective effect or reverse causality. Mechanisms underlying sun sensitivity might influence progression in progressive-onset MS.
    Type of Medium: Online Resource
    ISSN: 1352-4585 , 1477-0970
    URL: Article
    DOI: 10.1177/1352458511423778
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2012
    detail.hit.zdb_id: 2008225-3
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  • 4
    Online Resource
    Online Resource
    The effect of levetiracetam on tremor severity and functionality in patients with multiple sclerosis
    SAGE Publications ; 2009
    In:  Multiple Sclerosis Journal Vol. 15, No. 3 ( 2009-03), p. 371-378
    Details
    In: Multiple Sclerosis Journal, SAGE Publications, Vol. 15, No. 3 ( 2009-03), p. 371-378
    Abstract: Background Multiple sclerosis (MS) intention tremor is a disabling symptom, which is difficult to treat. Objectives To investigate the effects of levetiracetam, an antiepileptic drug, on tremor severity and related functionality in MS. Methods A randomized, double-blind, placebo-controlled, cross-over study examined the effects of 6 weeks of oral levetiracetam administration (starting dose = 250 mg/day, maximal dose = 2000 mg/day) in 18 MS patients with disabling intention tremor. Primary outcome was Fahn’s Tremor Rating Scale (FTRS) A & B. Secondary outcome measures were the nine-hole peg test, patient’s opinion rated with the visual analog scale, FTRS C, and an activities of daily life questionnaire and validated tremor indexes derived during the performance of a digitized spiral drawing task and a wrist step-tracking task. Repeated measures analysis of variance and Friedman tests were applied. Results In all, 14 patients completed the trial. Maximal dose intake ranged from 1000 to most commonly 2000 mg, depending on patients’ tolerance level. No significant effects of levetiracetam were found for any outcome measure. Further analyses on subgroups with different tremor severity showed no differential effects. Eight patients reported adverse events such as fatigue and stomach ache. Conclusions Levetiracetam intake of 2000 mg/day did not affect tremor severity or functionality in patients with MS.
    Type of Medium: Online Resource
    ISSN: 1352-4585 , 1477-0970
    URL: Article
    DOI: 10.1177/1352458508099142
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2009
    detail.hit.zdb_id: 2008225-3
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  • 5
    Online Resource
    Online Resource
    Modifiable factors influencing relapses and disability in multiple sclerosis
    SAGE Publications ; 2010
    In:  Multiple Sclerosis Journal Vol. 16, No. 7 ( 2010-07), p. 773-785
    Details
    In: Multiple Sclerosis Journal, SAGE Publications, Vol. 16, No. 7 ( 2010-07), p. 773-785
    Abstract: A growing body of literature indicates that the natural course of multiple sclerosis can be influenced by a number of factors. Strong evidence suggests that relapses can be triggered by infections, the postpartum period and stressful life events. Vaccinations against influenza, hepatitis B and tetanus appear to be safe. Surgery, general and epidural anaesthesia, and physical trauma are not associated with an increased risk of relapses. Factors that have been associated with a reduced relapse rate are pregnancy, exclusive breastfeeding, sunlight exposure and higher vitamin D levels. A number of medications, including hormonal fertility treatment, seem to be able to trigger relapses. Factors that may worsen progression of disability include stressful life events, radiotherapy to the head, low levels of physical activity and low vitamin D levels. Strong evidence suggests that smoking promotes disease progression, both clinically and on brain magnetic resonance imaging. There is no evidence for an increased progression of disability following childbirth in women with multiple sclerosis. Moderate alcohol intake and exercise might have a neuroprotective effect, but this needs to be confirmed.
    Type of Medium: Online Resource
    ISSN: 1352-4585 , 1477-0970
    URL: Article
    DOI: 10.1177/1352458510367721
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2010
    detail.hit.zdb_id: 2008225-3
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