Self-assessment reliability in multiple sclerosis: the role of socio-demographic, clinical, and quality of life aspects

Abstract Background Fatigue is among the most prevalent symptoms of multiple sclerosis (MS), and significantly detrimental to mental quality of life. We examined the role of depression and physical activity as mediators in the fatigue-QoL relationship in MS. Methods Using an international study cohort measuring a wide range of lifestyle and clinical factors, determinants of fatigue (Fatigue Severity Scale) and mental quality of life (MSQoL-54; QoL) were assessed in 2,104 participants using log-binomial and linear regression, respectively. Structural equation modelling (SEM) was used to assess the mediating role of depression and physical activity between fatigue and mental QoL. Results The median mental QoL score in the sample was 73.8/100. The mean fatigue score was 40.5/63, with 65.6% having clinically significant fatigue. In SEM analyses evaluating depression as a mediator of the fatigue-QoL relationship, mental QoL was 14.17-points lower in those with clinically significant fatigue, of which the indirect effect via depression accounted for over 30.8% (p < 0.001). This mediation effect was most pronounced for the Role Limitations from Emotional Issues (44.9%, p < 0.001) and Emotional Wellbeing (41.6%, p < 0.001) subdomains. Evaluating physical activity as a mediator of the fatigue-QoL relationship, mental QoL was 11.03-points lower in those with clinically significant fatigue, of which the indirect effect via physical activity accounted for only 1.0% (p = 0.001). Conclusions This study provides evidence that depression accounts for a majority of the fatigue-mental QoL relationship, while physical activity only plays a small role. While replication and longitudinal studies are required for validation, our findings may inform the development of treatments for reducing the impacts of fatigue and improving QoL in people with MS. Key messages Fatigue’s negative impact on emotional quality of life in multiple sclerosis is not a function of reduced ambulation but instead its impact on depression. Reducing depression may thus markedly improve quality of life in this population.

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Mediating Role of Resilience on Quality of Life in Individuals With Multiple Sclerosis: A Structural Equation Modeling Approach

Archives of Physical Medicine and Rehabilitation ◽

10.1016/j.apmr.2020.02.010 ◽

2020 ◽

Vol 101 (7) ◽

pp. 1152-1161 ◽

Cited By ~ 5

Author(s):

Susan L. Kasser ◽

Asim Zia

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Structural Equation Modeling ◽

Structural Equation ◽

Equation Modeling ◽

Mediating Role ◽

Modeling Approach

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Exercise in the management of multiple sclerosis relapses: current evidence and future perspectives

Neurodegenerative Disease Management ◽

10.2217/nmt-2019-0029 ◽

2020 ◽

Vol 10 (2) ◽

pp. 103-115 ◽

Cited By ~ 2

Author(s):

Scott Rooney ◽

Hani Albalawi ◽

Lorna Paul

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Steroid Therapy ◽

Recovery Of Function ◽

Current Evidence ◽

Future Perspectives

Relapses are a common feature of multiple sclerosis; however, recovery from relapses is often incomplete, with up to half of people experiencing residual disabilities postrelapse. Therefore, treatments are required to promote recovery of function and reduce the extent of residual disabilities postrelapse. Accordingly, this Perspective article explores the role of exercise in relapse management. Current evidence from two studies suggests that exercise in combination with steroid therapy improves disability and quality of life postrelapse, and may be more beneficial in promoting relapse recovery than steroid therapy alone. However, given the small number of studies and methodological limitations, further studies are required to understand the effects of exercise in relapse management and the mechanism through which exercise influences relapse recovery.

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Physical Activity in Prevention of Risk and Disability in Some Neurological Diseases

Physiotherapy and Health Activity ◽

10.1515/pha-2015-0004 ◽

2014 ◽

Vol 22 (1) ◽

pp. 21-27

Author(s):

Józef Opara

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Multiple Sclerosis ◽

Physical Disability ◽

Neurological Diseases ◽

Review Of The Literature ◽

Disability Progression ◽

Multiple Sclerosis Patients

Abstract The question of the role of physical activity in preventing disability in neurological diseases is the issue which is not in doubt. There is well known that physical activity in Parkinson`s disease and in Multiple Sclerosis patients is less than is the case in the general population. Numerous scientific studies have confirmed the low physical activity of people with PD and MS. Improving physical activity delays the progress of physical disability and has the effect on increasing the quality of life in those two diseases. In this paper an descriptive review of the literature devoted to the effect of physical activity on risk of PD and its impact on disability progression in PD and MS has been presented. The different recommendations for physical activity and different methods of assessment have been described.

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