Interventions with fatigue in neurological disorders (review)

Immink, M. A. (2014). Fatigue in neurological disorders: a review of self-regulation and mindfulness-based interventions. Fatigue: Biomedicine, Health & Behavior, (ahead-of-print), 1-17.

From the AbstractFatigue is prevalent in neurological disorders and is associated with increased disability and mortality rates. Currently, clinical assessment and management of fatigue is difficult as underlying mechanisms remain poorly understood.

This narrative review integrates models of pathological fatigue with the concepts of self-regulation and mindfulness. Findings from clinical trials testing the efficacy of mindfulness-based interventions (MBI) for fatigue in neurological disorders are also reviewed.

Recent definitions and models of pathological fatigue suggest that neurological disorders might instigate maladaptive changes in self-regulation leading to difficulties in sustaining movement and disproportionate levels of perceived effort. MBI might be effective in the management of fatigue since mindfulness training is thought to promote self-regulation by developing attention control and cognitive and emotional flexibility. Findings from a small number of clinical trials provide limited support for the efficacy of mindfulness-based interventions for fatigue in neurological disorders.

Further research is … needed to test the efficacy of MBI including large randomised controlled trials with active control conditions and which directly assess changes in mindfulness along with fatigue.