American Board of Internal Medicine (ABIM) Certification Practice Exam

Which non-pharmacologic treatment is appropriate for managing fatigue in multiple sclerosis?

1. Regular exercise

2. Medication adjustment

3. Acupuncture sessions

4. Home care assistance

The correct answer is: Regular exercise

Regular exercise is an appropriate non-pharmacologic treatment for managing fatigue in multiple sclerosis (MS). Studies have shown that engaging in a structured exercise program can significantly reduce fatigue levels, improve physical functioning, and enhance overall quality of life for individuals with MS. Exercise helps increase muscle strength, endurance, and cardiovascular fitness, which can counteract some of the fatigue associated with the disease. Additionally, exercise can have beneficial psychological effects, such as reducing depression and anxiety, which are common co-morbidities in MS patients and can contribute to fatigue. The types of exercises recommended may include aerobic activities, strength training, flexibility exercises, and even aquatic therapy, tailored to the individual's abilities and limitations due to their condition. In contrast, options such as medication adjustment and home care assistance may address other aspects of MS management but do not specifically target fatigue through lifestyle changes. Acupuncture, while sometimes considered for symptom relief, does not have well-established evidence supporting its efficacy for fatigue management in MS, making regular exercise the most appropriate and evidence-based choice for this specific symptom.