American Board of Internal Medicine (ABIM) Certification Practice Exam

Which non-pharmacologic treatment aligns with managing fatigue in multiple sclerosis?

1. Create a rigid daily schedule

2. Engage in regular exercise

3. Incorporate heavy physical activity

4. Limit sleep to increase alertness

The correct answer is: Engage in regular exercise

Engaging in regular exercise is a well-supported non-pharmacologic strategy for managing fatigue in individuals with multiple sclerosis (MS). Research shows that regular physical activity can help improve endurance, reduce feelings of fatigue, and enhance overall quality of life for MS patients. Exercise can also promote physical and mental well-being, leading to better functional outcomes. In multiple sclerosis, fatigue is a common and often debilitating symptom. A tailored exercise program, which may include aerobic activities, strength training, and flexibility exercises, can help increase energy levels and combat the feelings of fatigue. It is important to ensure that the exercise regimen is adapted to the individual’s capabilities to avoid exacerbations of symptoms or unnecessary strain. In contrast, a rigid daily schedule may create stress rather than reduce fatigue, as flexibility is often needed to accommodate the unpredictable nature of MS symptoms. Heavy physical activity might lead to increased fatigue rather than alleviation, as individuals may not have the energy reserves to sustain such exertion. Limiting sleep to increase alertness is counterproductive, as adequate rest is essential for managing fatigue; sleep deprivation can worsen overall fatigue and cognitive function. Therefore, regular exercise is advocated as a constructive approach to managing fatigue in patients with multiple sclerosis.