A model for fatigue generation and exercise prescription in multiple sclerosis patients

Persons with multiple sclerosis often suffer from fatigue primarily reflecting the burden of disease. The most direct manifestation is an increased sense of effort for even light activities. This can be thought of as the result of "inefficiency" in the neural programme that translates the motor intention into the proper pattern of muscle contractions. A model is proposed, based on the mismatch between the actual movement and the "efference copy" of the motor programme. Examples of exercises consistent with this model are provided.