Tension and Trauma Releasing Exercises for People with Multiple Sclerosis: A Randomized Controlled Trial.

Some studies suggests that mind-body therapies may be helpful for people with multiple sclerosis (PwMS) for symptom management. PwMS have reported benefits from Tension and Trauma Releasing Exercises (TRE); however, only limited research exists on the potential benefits of TRE. The study intended to determine whether an eight-week intervention of Tension and Trauma Releasing Exercises (TRE), a mind-body therapy, could primarily reduce fatigue and secondarily decrease other MS-related symptoms and to explore new, experimental outcome measures-sleep, hand motor function, gait function, cognitive function, or mood-for use in future research on TRE for PwMS. The research team performed a randomized controlled trial (RCT). The study took place at the Danish MS Society in Valby, Denmark. Participants were 28 members of the society who had an MS diagnosis and lived in the Copenhagen area. The research team performed simple randomization to allocate participants to the intervention and control groups. The intervention group received eight sessions of TRE and performed TRE daily at home, while the control group continued their usual care only. The primary outcome measure was self-reported fatigue measured via the Modified Fatigue Impact Scale (MFIS) at baseline and postintervention. Daily self-reported levels of nine MS-related symptoms as well as stress levels were obtained as secondary endpoints, using a digital tool, the MS PRO. For explorative purposes, daily measures of sleep duration and quality were obtained, via the Fitbit Charge 3 activity tracker. Finally, smartphone-based measurements of hand motor function, gait, cognition, and mood were obtained via the Floodlight Open (FLO) app. On primary outcomes, no significant differences between the TRE intervention group and the control group were detected at follow-up in the unadjusted analyses. However, when adjusted for imbalance in covariates, significant group differences were obtained in the MFIS total score (P = .03) as well as marginal significance in the MFISphys score (P = .06). The TRE intervention significantly reduced reported levels of spasticity and pain across the whole intervention period, and it showed a significant effect of gradual improvement in the 5 U-turn test over the study period. Positive effects on both primary and secondary outcomes from the TRE intervention were seen when adjusting for covariate imbalance. Therefore, it cannot be ruled out that TRE significantly improves fatigue in people with MS. Furthermore, the current study underlines the potential effect of bias-adjustment, when covariate imbalance is present. However, further research is needed to confirm the positive effects.