Scoping review: The effects of diet, physical activity and sleep on motor and physical fatigue in people with multiple sclerosis.

Physical and motor fatigue are debilitating symptoms common in multiple sclerosis (MS). Lifestyle interventions may be effective in managing MS-related fatigue. This scoping review aims to: (i) identify and summarise lifestyle interventions including those focused on diet, physical activity, and sleep, or multicomponent interventions for physical and motor fatigue management in MS; and (ii) provide recommendations for future research in this area. Database searches of MEDLINE (Ovid), Cochrane (Cochrane Library), Scopus (Elsevier), CINAHL (EBSCOhost), and Embase (Ovid) were conducted. To be included in this scoping review, studies were to be published in a peer reviewed scientific journal, focused on a non-pharmacological lifestyle intervention (physical activity, exercise, sleep, diet, or a combination), and written in English. Forty-one studies were included for analysis. Included participants were predominantly female, living with relapsing-remitting MS, with a median age of 48.3 years. The design of the studies comprised mainly of randomised control trials and pilot/feasibility studies. All included studies incorporated a physical activity intervention, with most examining aerobic/endurance exercise. Most studies reported an effect on improving physical/motor fatigue and a large proportion incorporated an endurance training program. To build on the current evidence and progress MS-fatigue related recommendations, further studies with larger sample sizes and a more inclusive range of MS types are required. Finally, with a gap of research investigating the role of diet and sleep on motor and physical fatigue in MS, research into this field is critically needed.