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| Name | Class |
|---|---|
| Oregon Health and Science University | OTHER |
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The purpose of this study is to compare two different educational programs for people with multiple sclerosis (MS), which is a common and often disabling disease of the central nervous system. MS causes many symptoms including difficulty walking, loss of balance or muscle coordination, fatigue, numbness and tingling and stiffness. The investigators want to determine which program is better at helping improve quality of life and MS symptoms. Both programs use material from the National Multiple Sclerosis Society (NMSS). Both programs include 6 weekly 2-hour class sessions. Up to 600 participants will be enrolled total in 4 VA sites, with about 150 at each site. There will be 10 study visits, all to occur within 11 months. These include 1 baseline visit, 6 two-hour class visits, and 3 follow-up data collection visits. The participants in Portland will also participate in a final 12 month followup visit. Participants will be randomly (by chance) assigned to be part of either group education program. They will have a 1:1 or 50% chance of being in either program.
Treatment of MS-related fatigue represents a significant challenge in providing symptomatic therapy for people with MS. In 1998 the MS Council for Clinical Practice Guidelines published Fatigue and MS, the first evidence based treatment guideline for MS recommending comprehensive treatment for fatigue. This guideline is widely distributed, but does not include a program for implementation. Fatigue: Take Control, is the first formal program modeled on the MS fatigue guidelines. This proposal entails performing a four-center single blind intent-to-treat randomized controlled two-arm parallel design trial of Fatigue: Take Control with MS participants to accomplish three Specific Aims.
Specific Aim #1: Demonstrate that Fatigue: Take Control reduces fatigue in people with MS who are ambulatory and not depressed at the end of the intervention and at three and six months after the intervention compared to a general MS group education program. The primary outcome measure will be the Modified Fatigue Impact Scale (MFIS) chosen for its multi-dimensional nature, recommended use in the Fatigue and MS guideline and sensitivity to change in the pilot study.
Specific Aim #2: Demonstrate that Fatigue: Take Control increases self-efficacy in people with MS who are ambulatory and not severely depressed. Fatigue affects a person's sense of control over his/her life. The investigators will use the MS Self Efficacy Scale (MSSE) for this secondary objective. This measure also demonstrated improvement in the pilot study.
Specific Aim #3: Demonstrate that Fatigue: Take Control results in changes in medication utilization, exercise participation, sleep and health-related quality of life in people with MS who are ambulatory and not depressed. Fatigue affects body functions/structure, activity and participation in all aspects of daily life. Fatigue: Take Control was created with the expectation that fatigue can be reduced by guiding individuals to make the environmental, behavioral and lifestyle changes necessary to manage MS fatigue. This objective will explore important secondary causes of fatigue that impact health-related quality of life by identifying participant changes in: timed walk using the time to walk 25 feet (T25-FW), medication utilization using a self-report medication diary, exercise participation using the self-report Rapid Assessment of Physical Activity (RAPA), sleep quality using the Pittsburgh Sleep Quality Index (PSQI) and changes in overall health-related quality of life using the SF-36.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Fatigue: Take Control | Experimental | Fatigue: Take Control, is the first formal education program modeled on the MS-related fatigue guideline |
|
| MS: Take Control | Active Comparator | MS: Take Control includes topics of interest to people with MS other than fatigue. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Fatigue: Take control | Behavioral | Fatigue: Take Control, is the first formal education program modeled on the MS-related fatigue guideline |
|
| Measure | Description | Time Frame |
|---|---|---|
| Modified Fatigue Impact Scale | The self-report, retrospective MFIS measures fatigue symptoms. The full-length MFIS consists of 21 items scored 0-4 for a total score between 0 and 84 and has a coefficient alpha of .81. The MFIS provides a total score and scores for each of three subscales (physical, cognitive and psychosocial) and lower scores on the MFIS and its subscales indicate less fatigue. This is the primary outcome measure for the proposed study and is widely used to assess fatigue in MS. | 4 months |
| Measure | Description | Time Frame |
|---|---|---|
| Multiple Sclerosis Self Efficacy Scale | The self-report, retrospective MSSE is an 18-item scale of self-efficacy specifically designed for MS patients. This easy to use self-report measure demonstrates internal consistency estimates of about .89 for the full scale and a .75 test-retest correlation. Higher scores on the MSSE indicate higher self-efficacy. Scores range from 180-1800. | 4 months |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Dennis N Bourdette, MD | VA Portland Health Care System, Portland, OR | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| North Florida/South Georgia Veterans Health System, Gainesville, FL | Gainesville | Florida | 32608 | United States | ||
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 29226778 | Result | Hugos CL, Chen Z, Chen Y, Turner AP, Haselkorn J, Chiara T, McCoy S, Bever CT Jr, Cameron MH, Bourdette D; VA MS Fatigue Study Group. A multicenter randomized controlled trial of two group education programs for fatigue in multiple sclerosis: Short- and medium-term benefits. Mult Scler. 2019 Feb;25(2):275-285. doi: 10.1177/1352458517745723. Epub 2017 Dec 11. | |
| 29761722 |
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Both Portland and Seattle LSIs have opted to send a letter with a copy of the study to participants in the study.
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| ID | Title | Description |
|---|---|---|
| FG000 | Fatigue: Take Control | Fatigue: Take Control, is the first formal education program modeled on the MS-related fatigue guideline Fatigue: Take control: Fatigue: Take Control, is the first formal education program modeled on the MS-related fatigue guideline |
| FG001 | MS: Take Control | MS: Take Control includes topics of interest to people with MS other than fatigue. MS: Take Control: MS: Take Control includes topics of interest to people with MS other than fatigue. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
Not provided
Not provided
| ID | Title | Description |
|---|---|---|
| BG000 | Fatigue: Take Control | Fatigue: Take Control, is the first formal education program modeled on the MS-related fatigue guideline Fatigue: Take control: Fatigue: Take Control, is the first formal education program modeled on the MS-related fatigue guideline |
| BG001 | MS: Take Control |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Modified Fatigue Impact Scale | The self-report, retrospective MFIS measures fatigue symptoms. The full-length MFIS consists of 21 items scored 0-4 for a total score between 0 and 84 and has a coefficient alpha of .81. The MFIS provides a total score and scores for each of three subscales (physical, cognitive and psychosocial) and lower scores on the MFIS and its subscales indicate less fatigue. This is the primary outcome measure for the proposed study and is widely used to assess fatigue in MS. | Posted | Mean | Standard Deviation | units on a scale | 4 months |
|
Not provided
Subjects were asked to self report all health problems that occurred during the study at each study visit regardless of relation to study. The study PI then reviewed what subjects had written and categorized each adverse event based on written information from the participant according to organ system class.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Fatigue: Take Control | Fatigue: Take Control, is the first formal education program modeled on the MS-related fatigue guideline Fatigue: Take control: Fatigue: Take Control, is the first formal education program modeled on the MS-related fatigue guideline |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| MS related | Nervous system disorders | Non-systematic Assessment | unrelated to research |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Chest pain. Undetermined orgin. | Cardiac disorders | Non-systematic Assessment | unrelated |
Not provided
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Cinda Hugos | Portland VA Medical Center | 503-220-8262 | 52338 | hugosc@ohsu.edu |
Not provided
| ID | Term |
|---|---|
| D009103 | Multiple Sclerosis |
| D005221 | Fatigue |
| ID | Term |
|---|---|
| D020278 | Demyelinating Autoimmune Diseases, CNS |
| D020274 | Autoimmune Diseases of the Nervous System |
| D009422 | Nervous System Diseases |
| D003711 | Demyelinating Diseases |
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| MS: Take Control | Behavioral | MS: Take Control includes topics of interest to people with MS other than fatigue. |
|
| Beck Depression Inventory II (BDI-II) | The self-report, retrospective BDI-II is a validated 21-item self-report measure of depression widely used in MS studies . Each item is scored between 0 and 3. It is reported to have good reliability (Cronbach's alpha of .81) and validity. Assessing for depression is part of the inclusion/exclusion criteria. Excluding subjects with severe depression is necessary to avoid confounding effects of fatigue and depression. Score range (0-63). Higher scores indicate greater depression. | 4 months |
| SF-36 | The SF-36 is a validated measure of health-related quality of life. It is sensitive to change, has appropriate psychometric properties and is frequently used in MS studies. Measures of health-related quality of life are recommended in the systematic review of self-management in neurological disorders. The range for the physical component score is 13.6-61.9. The range for the mental component scores is 15.6-70.0. | 4 months |
| Rapid Assessment of Physical Activity (RAPA) | The self-report, retrospective Rapid Assessment of Physical Activity (RAPA) was developed to provide an easily administered and interpreted means of assessing levels of physical activity among adults older than 50 years. The RAPA is an easy-to-use, valid measure of physical activity for use in clinical practice with older adults. A tool for older adults will be easy to use for people with MS who may not be regular exercisers. Each question has a 'Yes' or 'No' option. The total score of the first seven items is out of 7; participants choose which question corresponds to their activity level. Any score less than 6 is considered suboptimal. From these values we provided a percentage of the number of people exercising optimally in the RAPA Cardiovascular. Strength training and flexibility are scored separately (strength training = 1, flexibility = 2, both = 3). Based on total scores we provided a percentage of people at optimum strength and flexibility. | 4 months |
| Pittsburgh Sleep Quality Index (PSQI) | The Pittsburgh Sleep Quality Index (PSQI) is a self-rated questionnaire which assesses sleep quality and disturbances over a l-month time interval. Nineteen individual items generate seven "component" scores: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction. The sum of scores for these seven components yields one global score between 0-21. Higher scores indicate worse sleep quality. | 4 months |
| Timed 25 Foot Walk (T25-FW) | The time to walk 8 meters or 25 feet is strongly related to its ordinal counterpart the Ambulation Index (Spearman r = 0.91), without the variability that the ordinal scale reflects.T25-FW was used in this study to measure ambulation status and as an additional measure of mobility. The score for the T25-FWis the average of the two completed trials in seconds | 4 months |
| Baltimore VA Medical Center VA Maryland Health Care System, Baltimore, MD |
| Baltimore |
| Maryland |
| 21201 |
| United States |
| VA Portland Health Care System, Portland, OR | Portland | Oregon | 97239 | United States |
| VA Puget Sound Health Care System Seattle Division, Seattle, WA | Seattle | Washington | 98108 | United States |
| Hugos CL, Cameron MH, Chen Z, Chen Y, Bourdette D. A multicenter randomized controlled trial of two group education programs for fatigue in multiple sclerosis: Long-term (12-month) follow-up at one site. Mult Scler. 2019 May;25(6):871-875. doi: 10.1177/1352458518775920. Epub 2018 May 15. |
| 34347626 | Derived | Knowles LM, Hugos CL, Cameron MH, Haselkorn JK, Bourdette DN, Turner AP. Moderators of Improvements in Fatigue Impact After a Self-management Intervention in Multiple Sclerosis: A Secondary Analysis of a Randomized Controlled Trial. Am J Phys Med Rehabil. 2022 Apr 1;101(4):405-409. doi: 10.1097/PHM.0000000000001861. |
MS: Take Control includes topics of interest to people with MS other than fatigue. MS: Take Control: MS: Take Control includes topics of interest to people with MS other than fatigue. |
| BG002 | Total | Total of all reporting groups |
| Participants |
|
| Age, Continuous | Mean | Standard Deviation | years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| MS: Take Control |
MS: Take Control includes topics of interest to people with MS other than fatigue. MS: Take Control: MS: Take Control includes topics of interest to people with MS other than fatigue. |
|
|
|
| Secondary | Multiple Sclerosis Self Efficacy Scale | The self-report, retrospective MSSE is an 18-item scale of self-efficacy specifically designed for MS patients. This easy to use self-report measure demonstrates internal consistency estimates of about .89 for the full scale and a .75 test-retest correlation. Higher scores on the MSSE indicate higher self-efficacy. Scores range from 180-1800. | Posted | Mean | Standard Deviation | units on a scale | 4 months |
|
|
|
|
| Secondary | Beck Depression Inventory II (BDI-II) | The self-report, retrospective BDI-II is a validated 21-item self-report measure of depression widely used in MS studies . Each item is scored between 0 and 3. It is reported to have good reliability (Cronbach's alpha of .81) and validity. Assessing for depression is part of the inclusion/exclusion criteria. Excluding subjects with severe depression is necessary to avoid confounding effects of fatigue and depression. Score range (0-63). Higher scores indicate greater depression. | Posted | Mean | Standard Deviation | units on a scale | 4 months |
|
|
|
|
| Secondary | SF-36 | The SF-36 is a validated measure of health-related quality of life. It is sensitive to change, has appropriate psychometric properties and is frequently used in MS studies. Measures of health-related quality of life are recommended in the systematic review of self-management in neurological disorders. The range for the physical component score is 13.6-61.9. The range for the mental component scores is 15.6-70.0. | Posted | Mean | Standard Deviation | units on a scale | 4 months |
|
|
|
|
| Secondary | Rapid Assessment of Physical Activity (RAPA) | The self-report, retrospective Rapid Assessment of Physical Activity (RAPA) was developed to provide an easily administered and interpreted means of assessing levels of physical activity among adults older than 50 years. The RAPA is an easy-to-use, valid measure of physical activity for use in clinical practice with older adults. A tool for older adults will be easy to use for people with MS who may not be regular exercisers. Each question has a 'Yes' or 'No' option. The total score of the first seven items is out of 7; participants choose which question corresponds to their activity level. Any score less than 6 is considered suboptimal. From these values we provided a percentage of the number of people exercising optimally in the RAPA Cardiovascular. Strength training and flexibility are scored separately (strength training = 1, flexibility = 2, both = 3). Based on total scores we provided a percentage of people at optimum strength and flexibility. | Posted | Count of Participants | Participants | 4 months |
|
|
|
|
| Secondary | Pittsburgh Sleep Quality Index (PSQI) | The Pittsburgh Sleep Quality Index (PSQI) is a self-rated questionnaire which assesses sleep quality and disturbances over a l-month time interval. Nineteen individual items generate seven "component" scores: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction. The sum of scores for these seven components yields one global score between 0-21. Higher scores indicate worse sleep quality. | Posted | Mean | Standard Deviation | units on a scale | 4 months |
|
|
|
|
| Secondary | Timed 25 Foot Walk (T25-FW) | The time to walk 8 meters or 25 feet is strongly related to its ordinal counterpart the Ambulation Index (Spearman r = 0.91), without the variability that the ordinal scale reflects.T25-FW was used in this study to measure ambulation status and as an additional measure of mobility. The score for the T25-FWis the average of the two completed trials in seconds | Posted | Mean | Standard Deviation | seconds | 4 months |
|
|
|
|
| 12 |
| 109 |
| 86 |
| 109 |
| EG001 | MS: Take Control | MS: Take Control includes topics of interest to people with MS other than fatigue. MS: Take Control: MS: Take Control includes topics of interest to people with MS other than fatigue. | 10 | 109 | 82 | 109 |
| Surgery | Surgical and medical procedures | Non-systematic Assessment | unrelated to research |
|
| Fracture from a fall | Musculoskeletal and connective tissue disorders | Non-systematic Assessment | unrelated to research |
|
| Hospitalization for mental health | Social circumstances | Non-systematic Assessment | unrelated to research |
|
| Fracture from a fall | Musculoskeletal and connective tissue disorders | Non-systematic Assessment | unrelated to research |
|
| Cancer | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | Non-systematic Assessment | unrelated to research |
|
| Cancer | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | Non-systematic Assessment | unrelated to research |
|
| Constipation requiring hospitalization | Gastrointestinal disorders | Non-systematic Assessment | unrelated to research |
|
| Defibrulator change resulting in hospitalization | Cardiac disorders | Non-systematic Assessment | unrelated to research |
|
| Bee sting reaction | Immune system disorders | Non-systematic Assessment | unrelated to research |
|
| Hernia | Renal and urinary disorders | Non-systematic Assessment | unrelated to research |
|
| Social circumstances | Social circumstances | Non-systematic Assessment | unrelated to research |
|
| Syncopal event | Nervous system disorders | Non-systematic Assessment | unrelated to research |
|
| Difficulty breathing | Respiratory, thoracic and mediastinal disorders | Non-systematic Assessment | unrelated to research |
|
| Seizure | Nervous system disorders | Non-systematic Assessment | unrelated to research |
|
| MS Hug | Nervous system disorders | Non-systematic Assessment | unrelated to research |
|
| Chest pain | Cardiac disorders | Non-systematic Assessment | unrelated to research |
|
| MS exacerbation | Nervous system disorders | Non-systematic Assessment | unrelated to research |
|
| Shortness of breath and chest pains. | Cardiac disorders | Non-systematic Assessment | unrelated |
|
| nausea-diarrhea | Gastrointestinal disorders | Non-systematic Assessment | unrelated |
|
| Nausea | Gastrointestinal disorders | Non-systematic Assessment | unrelated |
|
| gastrointestinal pain | Gastrointestinal disorders | Non-systematic Assessment | unrelated |
|
| abdominal pain due to gastroparesis | Gastrointestinal disorders | Non-systematic Assessment | unrelated |
|
| bowel discomfort | Gastrointestinal disorders | Non-systematic Assessment | unrelated |
|
| hot flashes | General disorders | Non-systematic Assessment | unrelated |
|
| hot flashes, fatigue and tremors | General disorders | Non-systematic Assessment | unrelated |
|
| vertigo | General disorders | Non-systematic Assessment | unrelated |
|
| Dizziness/balance | General disorders | Non-systematic Assessment | unrelated |
|
| sedation/fainting from side effects of bladder medication | General disorders | Non-systematic Assessment | unrelated |
|
| headache/migraine | General disorders | Non-systematic Assessment | unrelated |
|
| Root canal | General disorders | Non-systematic Assessment | unrelated |
|
| Increase in headaches, vertigo, weakness and fatigue | General disorders | Non-systematic Assessment | unrelated |
|
| Headaches | General disorders | Non-systematic Assessment | unrelated |
|
| headache | General disorders | Non-systematic Assessment | unrelated |
|
| worsening headaches | General disorders | Non-systematic Assessment | unrelated |
|
| sinus infection | Infections and infestations | Non-systematic Assessment | unrelated |
|
| flu | Infections and infestations | Non-systematic Assessment | unrelated |
|
| Infection | Infections and infestations | Non-systematic Assessment | unrelated |
|
| Infection | Infections and infestations | Non-systematic Assessment | unrelated |
|
| fall | Musculoskeletal and connective tissue disorders | Non-systematic Assessment | unrelated |
|
| right hand pain | Musculoskeletal and connective tissue disorders | Non-systematic Assessment | unrelated |
|
| Broken tooth | Musculoskeletal and connective tissue disorders | Non-systematic Assessment | unrelated |
|
| Worsening focus and attention problems | Musculoskeletal and connective tissue disorders | Non-systematic Assessment | unrelated |
|
| Increased pain left side of body | Musculoskeletal and connective tissue disorders | Non-systematic Assessment | unrelated |
|
| fall due to lightheadness | Musculoskeletal and connective tissue disorders | Non-systematic Assessment | unrelated |
|
| pain/stiffness/locking in left hip (from torn ligament) | Musculoskeletal and connective tissue disorders | Non-systematic Assessment | unrelated |
|
| left knee pain | Musculoskeletal and connective tissue disorders | Non-systematic Assessment | unrelated |
|
| right leg weakness | Musculoskeletal and connective tissue disorders | Non-systematic Assessment | unrelated |
|
| increased spasticity | Musculoskeletal and connective tissue disorders | Non-systematic Assessment | unrelated |
|
| swollen foot | Musculoskeletal and connective tissue disorders | Non-systematic Assessment | unrelated |
|
| left arm pain | Musculoskeletal and connective tissue disorders | Non-systematic Assessment | unrelated |
|
| right thigh soreness on ambulation | Musculoskeletal and connective tissue disorders | Non-systematic Assessment | unrelated |
|
| weakenss in right thigh | Musculoskeletal and connective tissue disorders | Non-systematic Assessment | unrelated |
|
| Worsening of left knee. Hyperextension and weakness. | Musculoskeletal and connective tissue disorders | Non-systematic Assessment | unrelated |
|
| strained groin muscle | Musculoskeletal and connective tissue disorders | Non-systematic Assessment | unrelated |
|
| increased shakiness in right arm | Musculoskeletal and connective tissue disorders | Non-systematic Assessment | unrelated |
|
| right hip increased ache, stiffness | Musculoskeletal and connective tissue disorders | Non-systematic Assessment | unrelated |
|
| Right arm tendonitis | Musculoskeletal and connective tissue disorders | Non-systematic Assessment | unrelated |
|
| left shoulder/arm pain into mid back with back spasms | Musculoskeletal and connective tissue disorders | Non-systematic Assessment | unrelated |
|
| Fever, body aches | Musculoskeletal and connective tissue disorders | Non-systematic Assessment | unrelated |
|
| Increase in pain | Musculoskeletal and connective tissue disorders | Non-systematic Assessment | unrelated |
|
| fall | Musculoskeletal and connective tissue disorders | Non-systematic Assessment | unrelated |
|
| Increased pain following car accident | Musculoskeletal and connective tissue disorders | Non-systematic Assessment | unrelated |
|
| heel spur | Musculoskeletal and connective tissue disorders | Non-systematic Assessment | unrelated |
|
| Musculoskeletal | Musculoskeletal and connective tissue disorders | Non-systematic Assessment | unrelated |
|
| Musculoskeletal | Musculoskeletal and connective tissue disorders | Non-systematic Assessment | unrelated |
|
| MS related | Nervous system disorders | Non-systematic Assessment | unrelated |
|
| migraine | Nervous system disorders | Non-systematic Assessment | unrelated |
|
| cluster headaches | Nervous system disorders | Non-systematic Assessment | unrelated |
|
| worsening insomnia | Nervous system disorders | Non-systematic Assessment | unrelated |
|
| MS flareup; 5 days of sterioids (outpatient visits) | Nervous system disorders | Non-systematic Assessment | unrelated |
|
| Insomnia, dizziness, fatigue | Nervous system disorders | Non-systematic Assessment | unrelated |
|
| tremors and increased fatigue | Nervous system disorders | Non-systematic Assessment | unrelated |
|
| changes in peripheral vision | Nervous system disorders | Non-systematic Assessment | unrelated |
|
| chest pain related to MS flare-up | Nervous system disorders | Non-systematic Assessment | unrelated |
|
| fatigue | Nervous system disorders | Non-systematic Assessment | unrelated |
|
| MS exacerbation: leg weakness | Nervous system disorders | Non-systematic Assessment | unrelated |
|
| MS exacerbation: suspected optic neurtits (blurred vision) | Nervous system disorders | Non-systematic Assessment | unrelated |
|
| MS exacerbation:spine curvature, stiffness, spasticity | Nervous system disorders | Non-systematic Assessment | unrelated |
|
| facial numbness | Nervous system disorders | Non-systematic Assessment | unrelated |
|
| Increased leg weakness & declining mobility | Nervous system disorders | Non-systematic Assessment | unrelated |
|
| increased facial pain right side below right eye | Nervous system disorders | Non-systematic Assessment | unrelated |
|
| increased fatigue, spasticity, and tingling. | Nervous system disorders | Non-systematic Assessment | unrelated |
|
| Increased fatigue | Nervous system disorders | Non-systematic Assessment | unrelated |
|
| Left heel drop | Nervous system disorders | Non-systematic Assessment | unrelated |
|
| Mental disorientation | Nervous system disorders | Non-systematic Assessment | unrelated |
|
| epidural steroid injections for pain | Nervous system disorders | Non-systematic Assessment | unrelated |
|
| muscle spasms, neck | Nervous system disorders | Non-systematic Assessment | unrelated |
|
| Diagnosis of external snapping hip syndrome | Nervous system disorders | Non-systematic Assessment | unrelated |
|
| Loss of feeling in vulvar glands | Nervous system disorders | Non-systematic Assessment | unrelated |
|
| Muscle pain | Nervous system disorders | Non-systematic Assessment | unrelated |
|
| excessive fatigue: physical and cognitive change | Nervous system disorders | Non-systematic Assessment | unrelated |
|
| MS related | Nervous system disorders | Non-systematic Assessment | unrelated |
|
| MS related | Nervous system disorders | Non-systematic Assessment | unrelated |
|
| MS related | Nervous system disorders | Non-systematic Assessment | unrelated |
|
| UTI | Renal and urinary disorders | Non-systematic Assessment | unrelated |
|
| Recurrent right inguinal hernia | Renal and urinary disorders | Non-systematic Assessment | unrelated |
|
| Angioedema for side effects of bladder medication | Renal and urinary disorders | Non-systematic Assessment | unrelated |
|
| hernia; seen by primary care MD | Renal and urinary disorders | Non-systematic Assessment | unrelated |
|
| bladder issues exacerbated by levoquin antibiotic for bronchitis | Renal and urinary disorders | Non-systematic Assessment | unrelated |
|
| Brusing of uterus, and fallopian tubes | Reproductive system and breast disorders | Non-systematic Assessment | unrelated |
|
| Hemorragic ovarian cysts | Reproductive system and breast disorders | Non-systematic Assessment | unrelated |
|
| vaginal dryness | Reproductive system and breast disorders | Non-systematic Assessment | unrelated |
|
| Breathing/sinus difficutlies from deviated septum surgery | Respiratory, thoracic and mediastinal disorders | Non-systematic Assessment | unrelated |
|
| bronchitis | Respiratory, thoracic and mediastinal disorders | Non-systematic Assessment | unrelated |
|
| sinitus | Respiratory, thoracic and mediastinal disorders | Non-systematic Assessment | unrelated |
|
| Greater difficulty breathing. Cardiac tests negative. Referred to a pulmonologist. | Respiratory, thoracic and mediastinal disorders | Non-systematic Assessment | unrelated |
|
| persistant cough | Respiratory, thoracic and mediastinal disorders | Non-systematic Assessment | unrelated |
|
| Upper respiratory/cold | Respiratory, thoracic and mediastinal disorders | Non-systematic Assessment | unrelated |
|
| Upper respiratory/cold | Respiratory, thoracic and mediastinal disorders | Non-systematic Assessment | unrelated |
|
| Upper respiratory/cold | Respiratory, thoracic and mediastinal disorders | Non-systematic Assessment | unrelated |
|
| Piece of metal in foot | Skin and subcutaneous tissue disorders | Non-systematic Assessment | unrelated |
|
| skin rash | Skin and subcutaneous tissue disorders | Non-systematic Assessment | unrelated |
|
| Pruritis skin condition | Skin and subcutaneous tissue disorders | Non-systematic Assessment | unrelated |
|
| prutiis skin condition | Skin and subcutaneous tissue disorders | Non-systematic Assessment | unrelated |
|
| skin lesions possible due to injection reaction | Skin and subcutaneous tissue disorders | Non-systematic Assessment | unrelated |
|
| Skin problems | Skin and subcutaneous tissue disorders | Non-systematic Assessment | unrelated |
|
| Skin problems | Skin and subcutaneous tissue disorders | Non-systematic Assessment | unrelated |
|
| Skin problems | Skin and subcutaneous tissue disorders | Non-systematic Assessment | unrelated |
|
| increase in anxiety | Social circumstances | Non-systematic Assessment | unrelated |
|
| Emotional | Social circumstances | Non-systematic Assessment | unrelated |
|
| Emotional | Social circumstances | Non-systematic Assessment | unrelated |
|
Not provided
Not provided
Not provided
| D001327 | Autoimmune Diseases |
| D007154 | Immune System Diseases |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| .09 |
| Superiority |
| RAPA Flexibility |
|
| 0.4199 |
| Superiority |
| Wilcoxon (Mann-Whitney) | 0.854 | Superiority |