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One of the most prominent and disabling symptoms of MS is fatigue.

Currently, there is no effective medicine to reduce fatigue in people with MS.

However, in contrast, exercise , and particularly endurance, mixed, or 'other' training, may reduce self reported fatigue.

However, there are still some important methodological issues to overcome.

) A sensitive child who is repeatedly invalidated becomes confused and begins to distrust his own emotions. The Power of Positive Thinking was a big one at the time.

He fails to develop confidence in and healthy use of his emotional brain-- one of nature's most basic survival tools. She would have me read to her while she made dinner. I believe in being mindful of our feelings, and expressing them unless it would be harmful to someone else in which case, find a safe outlet – write, paint, maybe vent to a listening friend.

Purpose: The purpose of this article is to review multiple issues that can contribute to invalid symptom reporting and performance.

Quality of the evidence Even though these results are promising, it is worth noting some methods used in the trials may have affected the reliability of the results.

For example, most trials included a low number of participants and did not primarily aim to reduce fatigue (but, for instance, aimed to improve walking capability) with the assessment of fatigue being a secondary measure.

Treatment with exercise may be a way to reduce fatigue either directly by changing how the body works, for example hormonal function, or indirectly through improved physical activity and general health.

Study characteristics We searched scientific databases for clinical trials comparing exercise to no exercise or other treatments in adults with MS. Key results We found 45 trials, involving 2250 people with MS, assessing the effect of exercise and in people in a non-exercise group and did not find a significant difference.