Efficacy of targeted versus non-targeted exercise and behavioural interventions on fatigue in multiple sclerosis: systematic review and meta-analysis

Abstract

Review question(s) The specific objectives are to: (1) Provide a narrative synthesis of all the interventions, including a summary of the nature of the intervention using the Template for intervention Description and Replication (TiDieR), and assessment of study quality (risk of bias), alongside the standardised intervention effect sizes. As a detailed synthesis already includes studies evaluating interventions specifically targeting MS fatigue (ref: CRD42016033763), the narrative synthesis will focus on studies evaluating interventions that (a) do not specifically target fatigue, or (b) measured fatigue as a secondary outcome. (2) Conduct (pair-wise) meta-analyses to pool effect sizes across intervention types (exercise, behavioural, mixed) and estimate statistical heterogeneity. (3) Directly compare specific types of targeted versus non-targeted exercise, behavioural and combined interventions on fatigue in multiple sclerosis, using network meta-analyses. (4) Conduct exploratory moderator and sensitivity analyses to explore how treatment effects vary according to health care professional (HCP) contact, type of MS, and study quality (i.e. risk of bias).