Comparing the Effectiveness of Vestibular Rehabilitation and Frenkel Exercise on Fatigue Reduction in Patients with Multiple Sclerosis: A Randomized Controlled Trial

Background: Fatigue is one of the most common complaints in people with Multiple Sclerosis (MS). The use of non-pharmacological interventions, such as exercise, may be effective in reducing fatigue in these patients. Objectives: This study aimed to evaluate the effect of vestibular rehabilitation and Frenkel exercise on fatigue in patients with multiple sclerosis. Methods: This study was a controlled randomized clinical trial. Seventy-five patients, who had medical records at the society of special diseases of the Yasuj University of Medical Sciences, Iran, in 2016, were randomly assigned to three groups, namely, vestibular rehabilitation, Frenkel, and control. The program lasted for 12 weeks (three sessions per week). Fatigue was measured by the Fatigue Impact Scale (FIS) before the intervention, and after that, at six and twelve weeks after the initiation of intervention. Results: The mean score of fatigue in both experimental groups was decreased in a statistically significant manner after the end of the exercises, whereas it was increased in the control group. The reduction in fatigue was statistically significant in the vestibular rehabilitation exercise in comparison with the Frenkel exercise. The total fatigue in the vestibular rehabilitation group at six and twelve weeks after the intervention was -14.1 and -33.1, respectively, in comparison with before the interventions yet in the Frenkel group it was reported as -8 and -17.9, respectively. The comparison of the FIS subscales showed that there was a difference between the vestibular rehabilitation and Frenkel group in both the FIS physical (P = 0.001) and the psychosocial subscales (P = 0.01), yet no difference was observed between the two groups in the FIS cognitive subscale (P = 0.1) at twelve weeks after the intervention. Conclusions: Both vestibular rehabilitation and Frenkel exercise could reduce fatigue in MS patients, however, vestibular rehabilitation was more effective compared to the Frenkel exercise in reducing fatigue.