Table 1.
Characteristics of the Ten Trials Included in the Meta-Analysis
| Study | Sample size (I/C) | Mean age (years) (I/C) | Sex, female (frequency) (I/C) | Treatment duration (weeks) | Outcome assessments | Experimental group intervention | Control group intervention |
|---|---|---|---|---|---|---|---|
| Bastani et al.16 | 50/50 | 31.88/31.90 | 100% | 4 | Fatigue: FSS | Acupressure (ST36, SP6, and LI4) 18 min/30 sessions |
Sham massage (ST36, SP6, and LI4) |
| Hughes et al.17 | 35/36 | 50/53 | 60%/56.7% | 10 | Fatigue: FSS; pain: VAS; spasms: VAS; psychological state: MSIS; and physical function: MSIS | Reflexology 45 min/10 sessions |
Sham reflexology |
| Mackereth et al.18 | 25/25 | 48.12/52.52 | 80%/72% | 6 | Pain: SF-36; psychological state: SF-36; and physical function: SF-36 | Reflexology 40 min/24 sessions |
Progressive muscle relaxation training |
| Miller et al.19 | 10/10 | 53.6/58.1 | 60%/30% | 8 | Pain: VAS; spasms: VAS; psychological state: MSIS; and physical function: MSIS | Reflexology 60 min/10 sessions |
Sham reflexology |
| Nazari et al.20 | 25/25 | 34.4/33.9 | NR | 4 | Pain: NRS | Reflexology Solar plexus, hypothalamus, pituitary gland, spinal cord, kidney 1, adrenal glands, and pelvis 45 min/10 sessions |
Relaxation |
| Negahban et al.21 | 24/24 | 36.33/36.83 | NR | 5 | Fatigue: FSS; pain: VAS; and spasms: MAS | Swedish massage 30 min/15 sessions |
Standard medical care |
| Rahimi et al.22 | 53/53 | NR | 75%/71.4% | 4 | Fatigue: FSS | Self-acupressure (HT7 and GV29) 30–40 min/30 sessions |
Sham self-acupressure (nonacupoints) |
| Sajadi et al.23 | 33/30 | 34.52/32.12 | 93.9%/93.3% | 6 | Fatigue: SF-36; pain: SF-36; psychological state: SF-36; and physical function: SF-36 | Rwo Shur method of reflexology (stomach, liver, small intestine, large intestine, and solar plexus) 60–80 min/12 sessions |
Sham reflexology |
| Sajadi et al.24 | 35/35 | NR | 93.3%/93.3% | 4 | Fatigue: FIS | Rwo Shur method of reflexology (pituitary gland, hypothalamus, pineal gland, and solar plexus) 60–80 min/12 sessions |
Sham reflexology |
| Siev-Ner et al.25 | 27/26 | 42.6/49.2 | 62.9%/65.4% | 4 | Spasms: Ashworth Scale | Reflexology 45 min/11 sessions |
Sham reflexology |
C, control group; FIS, Fatigue Impact Scale; FSS, Fatigue Severity Scale; I, intervention group; MAS, Modified Ashworth Scale; MSIS, Multiple Sclerosis Impact Scale; NR, not reported; NRS, Numeric Rating Scale; SF-36, The medical outcomes study (MOS) 36-item short-form health survey; VAS, Visual Analog Scale.