CA03
Assessment of Community Acupuncture for Fatigue in Persons with Multiple Sclerosis

Thursday, May 25, 2017
B2 (New Orleans Convention Center)
Jennifer A. Ruiz, DPT , Mandell Center for Multiple Sclerosis, Mount Sinai Rehabilitation Hospital, Trinity Health Of New England, Hartford, CT
Christopher Gaunya, M.Ac., L.Ac., Dipl.Ac. , Center for Integrative Medicine, St. Francis Hospital and Medical Center, Hartford, CT
Kayla M. Olson, MA , Mandell Center for Multiple Sclerosis, Mount Sinai Rehabilitation Hospital, Trinity Health Of New England, Hartford, CT
Matthew Farr, M.S., P.T. , Mandell Center for Multiple Sclerosis, Mount Sinai Rehabilitation Hospital, Hartford, CT
Kathleen Mueller, M.D. , Center for Integrative Medicine, St. Francis Hospital and Medical Center, Hartford, CT
Jennifer A. Ruiz, DPT , Mandell Center for Multiple Sclerosis, Mount Sinai Rehabilitation Hospital, Trinity Health Of New England, Hartford, CT



Background: Fatigue is reported by over 85% of persons with multiple sclerosis (MS). Among that group, 65% rank fatigue as one of their three most debilitating MS symptoms. Fatigue can negatively impact activities of daily living, and interfere with work, family life and social activities. Fatigue is known to impact symptoms related to sleep abnormalities, anxiety and mood. In the clinical setting, attempts are made to manage MS related fatigue using medication, physical rehabilitation, energy conservation, behavior/cognitive therapies, and complementary therapies such as acupuncture. Preliminary studies suggest acupuncture may improve fatigue in at least a percentage of pwMS.

Objectives: To explore the use of community acupuncture for symptom management of fatigue, anxiety and mood in pwMS who report at least moderate levels of fatigue.

Methods: A total of 11 pwMS recruited from the community participated in this study. Over an 8 week period, subjects received a total of 8 sessions of community acupuncture seated in a “zero gravity” reclining chair. Needles were retained for a minimum of 45 minutes to a maximum of 1 hour and then removed. Pre and post acupuncture, the visual analog scale (VAS) was used to collect symptoms over the past month and on the day of the assessment for the following: Fatigue (VAS-FM and VAS-FD respectively), anxiety (VAS-AM and VAS-AD respectively), and perceived general health (VAS-GM and VAS-GD respectively). Additional outcomes included: depression (Center for Epidemiologic Studies Depression Scale [CES-D]), age, gender and disease duration. Change from baseline data were analyzed using Wilcoxon signed rank test (p-value <0.05).

Results: A significant decrease in fatigue experienced over the past month (median change: -25.0, p-value: .016) post 8 weeks of acupuncture was found compared to baseline (pre). Although not significant, the following improvements (median change, p-value) were observed when comparing pre to post 8 weeks of acupuncture: decreased VAS-FD (-5.0, .240), CES-D (-3.0, .114), VAS-AM (-5.0, .172), VAS-AD (0.0, .635); and increased VAS-GM (10.0, .201), VAS-GD (5.0, .260); each measure had at least 45% of participants show improvement.

Conclusions: This study further supports that community acupuncture may improve MS related fatigue in pwMS reporting at least moderate levels of fatigue. Although only fatigue experienced over the past month in which the participants were receiving acupuncture was significant, all outcome measures collected, demonstrated a positive change. This data should be utilized in support of a larger study to examine dosing and response to community acupuncture in pwMS.