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Cryotherapy and self-reported fatigue in individuals with multiple sclerosis: A systematic review
Annie Campbell, Benjamin Killen, et al
Received 30 Jun 2019, Accepted 26 Sep 2019, Published online: 08 Oct 2019
Abstract
Background: Multiple Sclerosis (MS) is a degenerative neurological condition leading to central nervous system demyelination. Research shows that cryotherapy may increase function and decrease the symptoms of MS.
Objective: To evaluate the effects of cooling interventions compared to placebo/sham or no treatment on self-reported fatigue in individuals with MS.
Methods: The authors searched two databases (PubMed and EMBASE) in May 2019 using search terms related to cooling techniques and MS-related fatigue. Patients with comorbidities unrelated to MS were excluded. A risk of bias assessment was performed by two authors utilizing quality assessment tools related to the type of study including PEDro, NIH Quality Assessment for Case Series Studies (NIHQACSS), and the NIH Quality Assessment Tool for Before-After (Pre-Post) Studies with No Control Group (NIHQATBASNCG).
Results: Eight studies were included for review. Six showed significant differences between groups in favor of the cooling group. Four showed significant effect sizes in favor of the cooling group within and between groups. Risk of bias results were as follows: PEDro scores for six studies ranged 4/10 to 6/10, an NIHQACSS score of 9/9, and an NIHQATBASNCG score of 9/12.
Conclusions: Three of the four studies that examined chronic cooling demonstrated large effect sizes favoring the cooling group. Three of the four studies that examined acute cooling demonstrated significant differences favoring the cooling group with the exception reporting a small, significant effect size that favored the cooling group. Seven of eight included studies revealed some benefit of cooling intervention on fatigue.
Annie Campbell, Benjamin Killen, et al
Received 30 Jun 2019, Accepted 26 Sep 2019, Published online: 08 Oct 2019
Abstract
Background: Multiple Sclerosis (MS) is a degenerative neurological condition leading to central nervous system demyelination. Research shows that cryotherapy may increase function and decrease the symptoms of MS.
Objective: To evaluate the effects of cooling interventions compared to placebo/sham or no treatment on self-reported fatigue in individuals with MS.
Methods: The authors searched two databases (PubMed and EMBASE) in May 2019 using search terms related to cooling techniques and MS-related fatigue. Patients with comorbidities unrelated to MS were excluded. A risk of bias assessment was performed by two authors utilizing quality assessment tools related to the type of study including PEDro, NIH Quality Assessment for Case Series Studies (NIHQACSS), and the NIH Quality Assessment Tool for Before-After (Pre-Post) Studies with No Control Group (NIHQATBASNCG).
Results: Eight studies were included for review. Six showed significant differences between groups in favor of the cooling group. Four showed significant effect sizes in favor of the cooling group within and between groups. Risk of bias results were as follows: PEDro scores for six studies ranged 4/10 to 6/10, an NIHQACSS score of 9/9, and an NIHQATBASNCG score of 9/12.
Conclusions: Three of the four studies that examined chronic cooling demonstrated large effect sizes favoring the cooling group. Three of the four studies that examined acute cooling demonstrated significant differences favoring the cooling group with the exception reporting a small, significant effect size that favored the cooling group. Seven of eight included studies revealed some benefit of cooling intervention on fatigue.