Rhodiola rosea for mental and physical fatigue in nursing students: a randomized controlled trial

Salima Punja, Larissa Shamseer, Karin Olson, Sunita Vohra, Salima Punja, Larissa Shamseer, Karin Olson, Sunita Vohra

Abstract

Background: Fatigue is one of many unintended consequences of shift work in the nursing profession. Natural health products (NHPs) for fatigue are becoming an increasingly popular topic of clinical study; one such NHP is Rhodiola rosea. A well-designed, rigorously conducted randomized controlled trial is required before therapeutic claims for this product can be made.

Objective: To compare the efficacy of R. rosea with placebo for reducing fatigue in nursing students on shift work.

Design: A parallel-group randomized, double-blinded, placebo-controlled trial of 18-55 year old students from the Faculty of Nursing from the University of Alberta, participating in clinical rotations between January 2011 and September 2011.

Interventions: Participants were randomized to take 364 mg of either R. rosea or identical placebo at the start of their wakeful period and up to one additional capsule within the following four hours on a daily basis over a 42-day period.

Outcomes: The primary outcome was reduction in fatigue over the 42-day trial period measured using the Vitality-subscale of the RAND-36, cross-validated by the visual analogue scale for fatigue (VAS-F). Secondary outcomes included health-related quality of life, individualized outcomes assessment, and adverse events.

Results: A total of 48 participants were randomized to R. rosea (n = 24) or placebo (n = 24). The mean change in scores on the Vitality-subscale was significantly different between the study groups at day 42 in favor of placebo (-17.3 (95% CI -30.6, -3.9), p = 0.011), The mean change in scores on the VAS-F was also significantly difference between study groups at day 42 in favour of placebo (1.9 (95% CI 0.4, 3.5), p = 0.015). Total number of adverse events did not differ between R. rosea and placebo groups.

Conclusion: This study indicates that among nursing students on shift work, a 42-day course of R. Rosea compared with placebo worsened fatigue; however, the results should be interpreted with caution.

Trial registration: Clinicaltrials.gov NCT01278992.

Conflict of interest statement

Competing Interests: This trial was funded by the Alberta Agriculture and Rural Development, Government of Alberta through AVAC Ltd. This does not alter the authors’ adherence to PLOS ONE policies on sharing data and materials.

Figures

Figure 1. Participant flow.
Figure 1. Participant flow.
Figure 2. Daily severity of first patient-reported…
Figure 2. Daily severity of first patient-reported symptom and fatigue on the MYMOP.
Legend: Red: First symptom-Placebo Green: First symptom- R. Rosea Blue: Fatigue-Placeo Yellow: Fatigue- R. Rosea.

References

    1. Carrier J, Monk TH (2000) Circadian rhythms of performance: new trends. Chronobiol Int 17(6): 719–732.
    1. Winget CM, DeRoshia CW, Holley DC (1985) Circadian rhythms and athletic performance. Med Sci Sports Exerc 17(5): 498–516.
    1. College and Association of Registered Nurses of Alberta. 2009. Available: . Accessed: 2011 Nov 5.
    1. Hughes R, Stone P (2004) The perils of shift work: evening shift, night shift, and rotating shifts: are they for you? Am J Nurs 104(9): 60–63.
    1. Jansen NW, van Amelsvoort LG, Kristensen TS, van den Brandt PA, Kant IJ (2003) Work schedules and fatigue: a prospective cohort study. Occup Environ Med Jun 60 Suppl 1: i47–53.
    1. Krueger GP (1994) Fatigue, Performance and Medical Error. In: Bogner NS, editor. Human Error in Medicine. Hillsdale, NJ: L. Erlbaum Associates. p. 311–326.
    1. Admi H, Tzischinsky O, Epstein R, Herer P, Lavie P (2008) Shift work in nursing: is it really a risk factor for nurses’ health and patients’ safety? Nursing Economics 26(4): 250–257.
    1. Everitt BJ, Wolf ME (2002) Psychomotor Stimulant Addiction: A Neural Systems Perspective. Journal of Neuroscience 22(9): 3312.
    1. Health Canada. (2005) Baseline natural health products survey among consumers. Available: . Accessed: 2011 Nov 5.
    1. Brekhman I, Dardymov IV (1969) New substances of plant origin which increase non-specific resistance. Ann Rev Pharmacol 9: 419–430.
    1. Hung SK, Perry R, Ernst E (2011) The effectiveness and efficacy of Rhodiola Rosea L: A systematic review of randomized clinical trials. Phytomedicine 18: 235–244.
    1. Ishaque S, Shamseer L, Bukutu C, Vohra S (2012) Rhodiola rosea for mental and physical fatigue: a systematic review. BMC Complementary and Alternative Medicine 12: 70.
    1. Schulz KF, Altman DG, Moher D (2010) for the CONSORT Group (2010) CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials. BMJ 340: c332.
    1. Hays RD, Morales LS (2001) The RAND-36 measure of health-related quality of life. Ann Med 33: 350–357.
    1. Obidoa CA, Reisine SL, Cherniack M (2010) How Does the SF-36 Perform in Healthy Populations? A Structured Review of Longitudinal Studies. Journal of Social, Behavioral, and Health Sciences 4(1): 30–40.
    1. Hemingway H, Stafford M, Stansfeld S, Shipley M, Marmot M (1997) Is the SF-36 a valid measure of change in population health? Results from the Whitehall II Study. BMJ 315(7118): 1273.
    1. Lee KA, Hicks G, Nino-Murcia G (1991) Validity and reliability of a scale to assess fatigue. Psychiatry Research 36(3): 291–298.
    1. Paterson C (1996) Measuring outcome in primary care: a patient-generated measure, MYMOP, compared to the SF-36 health survey. BMJ 312: 1016–20.
    1. Ellis JM, Reddy P (2002) Effects of Panax ginseng on quality of life. Ann Pharmacother 36(3): 375–379.
    1. Shevtsov VA, Zholus BI, Shervarly VI, Vol’skij VB, Korovin YP, et al. (2003) A randomized trial of two different doses of a SHR-5 Rhodiola rosea extract versus placebo and control of capacity for mental work. Phytomedicine: International Journal of Phytotherapy and Phytopharmacology 10(2–3): 95–105.
    1. Olsson EM, von Scheele B, Panossian AG (2009) A randomised, double-blind, placebo-controlled, parallel-group study of the standardised extract shr-5 of the roots of Rhodiola rosea in the treatment of subjects with stress-related fatigue. Planta Med Feb 75(2): 105–112.

Source: PubMed

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