Table 3 Characteristics of included studies
Study | Type of Study | Participant demographics | Baseline therapies or pharmacological intervention | Fatigue protocol | Fatigue evaluation | Outcome measures | Measurement position | Main outcomes | Conclusion |
|---|---|---|---|---|---|---|---|---|---|
Drebinger et al. (2020) | Prospective observational | N: 43 (Women = 20, Men = 23) Age: 48.6 (13.7) MS type: NA EDSS: 1–6 Disease duration: NA | Disease-modifying therapies (12), antidepressants (3), fampridine (2), other CNS medication (8), and other non-CNS medication (15) | 6MWT | Fatigue scale for motor and cognitive functions questionnaire | Sway closed stance eyes open angular speed (degrees/s), Sway closed stance eyes closed angular speed (degrees/s), Romberg ratio angular speed (-) | Static balance function performance in eyes open and eyes closed conditions | Postural sway with closed eyes (P < 0.05) Postural sway with open eyes (P < 0.05) Romberg ratio (P > 0.05) | Postural sway will increase after 6 min of walking. |
Jallouli et al. (2022) | Quasi-experimental | N: 18 (Women = 11, Men = 7) Age: 30.7 (8.2) MS type: RRMS EDSS: 0–4 Disease duration: 5 years | NA | 1) 3 sets of 5-repetition sit-to-stand test 2) 6MWT 3) 3 sets of 5-repetition sit-to-stand test | Visual analogue scale of fatigue | Mean COP velocity (mm/s), COP sway area (mm2) | Bipedal and unit pedal postural balance performance in eyes open and eyes closed conditions | COP velocity (P < 0.01) COP sway area (P < 0.01) | Fatiguing tasks negatively affected postural control. |
Sanni et al. (2021) | Quasi-experimental | Number: 6 (Women = 3, Men = 3) Age: 47.4 (NA) MS type: RRMS and PPMS PDDS: 3–5 Disease duration: 5 years | NA | 6MWT | Visual analogue scale of fatigue | COP ellipse sway area with eyes closed and eyes open (mm2) | Static balance with eyes closed and eyes open | 69% increase in the COP ellipse sway area with eyes opened (Cohen’s D 0.5) 20% increase in the COP ellipse sway area with eyes closed (Cohen’s D 0.2) | Six minutes of self-paced walking worsened balance. among people with MS. |
Karpatkin et al. (2013) | Quasi-experimental | N: 29 (Women = 20, Men = 9) Age: 52.0 (8.8) MS type: RRMS, SPMS, and PPMS EDSS: 1.5-6 Disease duration: 14 years | Antispasticity medication: 12 individuals Antifatigue medication: 9 individuals | 6MWT | Fatigue severity scale | Berg balance scale score (-) | Static balance with eyes open | BBS (P < 0.001) | Fatigue alters the performance of people with MS on the BBS. |
Emmerik et al. (2010) | Quasi-experimental | N: 24 (Women = 24, Men = 0) Age: 53.9 (8.9) MS type: RRMS, SPMS, and PPMS EDSS: 2–6 Disease duration: 15 years | MS group: MS drugs (9), anti-depressants (5), anti-fatigue (3), anti-spasticity (3) and anti-convulsive/sedative (4) | Strength testing for both legs (Peak knee extensor and dorsiflexor isometric torque and isotonic power) | Visual analogue scale of fatigue | Loading asymmetry (%), medial-lateral COP displacement (mm), anterior-posterior COP displacement (mm) | Static (with eyes open and eyes closed) and dynamic balance | COP loading asymmetry (P > 0.05) COP anterior displacement (P < 0.05) COP posterior displacement (P > 0.05) COP lateral displacement (P > 0.05) | Additional fatigue in the MS group did affect postural control in the more challenging balance conditions. |