Impact of fatigue in multiple sclerosis: the Fatigue Impact Scale for Daily Use (D-FIS)

2007 ◽  
Vol 13 (5) ◽  
pp. 645-651 ◽  
Author(s):  
J. Benito-León ◽  
P. Martínez-Martín ◽  
B. Frades ◽  
M.L. Martínez-Ginés ◽  
C. de Andrés ◽  
...  

Objective The Fatigue Impact Scale for Daily Use (D-FIS) is an eight-item instrument designed to measure subjective daily experience of fatigue. This study sought to determine the metric properties of the D-FIS in multiple sclerosis (MS) patients. Methods Sixty-eight patients with operationally-defined MS and fatigue (54.8% of the sample) underwent the D-FIS. Usual clinical measures for MS, the Montgomery-Asberg Depression Rating Scale (MADRS) and the Functional Assessment of Multiple Sclerosis (FAMS) were also applied. In addition, patients with fatigue completed the Fatigue Descriptive Scale, the Multidimensional Fatigue Inventory (MFI), a Visual Analogue Scale for Fatigue (VAS-F), and a Global Perception of Fatigue Scale (GPF). Results Full computable data, 95.6%; both floor and ceiling effect=1.54%; item-total correlation =0.62 (item 1) to 0.84 (item 6); Cronbach's alpha =0.91; item homogeneity =0.55; standard error of measurement =3.18; convergent validity with other fatigue measures = -0.57 (VAS-F); 0.52 (GPF); and 0.46 (MFI-general fatigue). Test-retest reliability (ICC) =0.81. There was a strong association between health-related quality of life (HRQoL) (FAMS) and D-FIS (rS=0.70). Conclusions In this study, D-FIS proved to be a feasible and valid instrument for measuring MSrelated fatigue, a frequent symptom associated with deterioration of patients' HRQoL. Multiple Sclerosis 2007; 13: 645-651. http://msj.sagepub.com

2008 ◽  
Vol 14 (3) ◽  
pp. 383-390 ◽  
Author(s):  
Myla D Goldman ◽  
Ruth Ann Marrie ◽  
Jeffrey A Cohen

Objective To assess the characteristics of the 6-min walk (6MW) in multiple sclerosis (MS) subjects of varied disability, and controls. To assess the correlation of 6MW to subjective measures of fatigue, health status and ambulation using the modified fatigue impact scale (MFIS), short form-36 Health Questionnaire physical component score and MS walking scale (MSWS). Methods Forty MS expanded disability status scale [(EDSS) 0—6.5] and 20 control subjects were recruited from a MS outpatient clinic. Subjects completed survey material and three 6MWs with 1-h interval rest in a single study visit. Results There was no practice effect or fatigability with repeat 6MW tests with a one-h rest period between test sessions. The 6MW had excellent intra-[intraclass correlation coefficient (ICC) = 0.95] and inter-rater (ICC = 0.91) reliability. MS subjects demonstrated reduced 6MW distance and speed compared with controls ( P < 0.0001). Within the MS population 6MW distance was significantly reduced with increasing disability ( P = 0.05). Compared with the EDSS, the 6MW had a stronger correlation to subjective measures of ambulation and physical fatigue: MSWS ( r = -0.81 versus 0.69) and MFISphy (0.66 versus 0.63). Conclusions The 6MW is a feasible, reproducible, and reliable measure in MS. MS subjects demonstrate motor fatigue in both 6MW distance and speed compared with controls. In MS subjects there is an inverse relationship between motor fatigue and disability. 6MW has a strong correlation to subjective measures of ambulation and physical fatigue. Multiple Sclerosis 2008; 14: 383—390. http://msj.sagepub.com


2019 ◽  
Vol 5 (4) ◽  
pp. 205521731988798 ◽  
Author(s):  
Virginia Meca-Lallana ◽  
María Brañas-Pampillón ◽  
Yolanda Higueras ◽  
Antonio Candeliere-Merlicco ◽  
Yolanda Aladro-Benito ◽  
...  

2018 ◽  
Vol 25 (11) ◽  
pp. 1496-1505 ◽  
Author(s):  
Ayse Kuspinar ◽  
Nancy E Mayo

Background: Preference-based measures of health-related quality of life (HRQL) are used as primary or secondary endpoints in multiple sclerosis (MS) research. Objective: The purpose of this paper was to evaluate the structural, convergent, and known-groups validity of the preference-based multiple sclerosis index (PBMSI) of HRQL in people with MS. Methods: Participants were recruited from three MS clinics in Montreal. Structural validity was assessed using polychoric correlation coefficients and factor analysis. To assess convergent validity, hypotheses were formulated about the strength of correlations between the PBMSI and other HRQL measures. Known-groups validity was assessed against different measures of disability. Results: The average age of the sample was 46 and 77% were women. Factor analysis supported the structural validity of the PBMSI; the items collectively were measuring one underlying construct. The PBMSI showed convergent validity against generic measures of HRQL, and known-groups validity between persons with different levels of disability. Conclusion: The results of this study support the construct validity of the PBMSI as an outcome measure of HRQL in MS. The PBMSI overcomes limitations observed with currently used HRQL measures in MS and may be used to contrast different interventions for people with MS.


2017 ◽  
Vol 24 (8) ◽  
pp. 1105-1114 ◽  
Author(s):  
Miklos Palotai ◽  
Andrea Mike ◽  
Michele Cavallari ◽  
Erzsebet Strammer ◽  
Gergely Orsi ◽  
...  

Background: Reports on the relationships between white matter lesion load (WMLL) and fatigue and anxiety in multiple sclerosis (MS) are inconsistent. Objective: To investigate the association of total and tract-specific WMLL with fatigue and anxiety. Methods: Total and regional T2 WMLL was assessed for 19 tracts in 48 MS patients (30 females). ICBM-DTI-81 Atlas-based parcellation was combined with WMLL segmentation of T2-weighted magnetic resonance imaging (MRI). Fatigue, anxiety, and depression were assessed using Fatigue Impact Scale, State Trait Anxiety Inventory, and Beck Depression Inventory, respectively. Results: Fatigue, anxiety, and depression showed significant inter-correlation. We found no association between fatigue and total or regional WMLLs, whereas anxiety was associated with total and regional WMLLs in nine tracts. After adjusting for total WMLL, age, and depression, only the column and body of the fornix (CBF) remained significantly associated with anxiety. Post hoc analyses showed no CBF lesions on T1-weighted MRI and suggested, but could not confirm, that the septum pellucidum might play a role in the pathogenesis of anxiety. Conclusion: Our results suggest that anxiety in MS patients may have a neuropathological substrate in the septo-fornical area, which requires further validation using larger sample size and ultra-high-field MRI in targeted prospective studies.


2009 ◽  
Vol 24 (1) ◽  
pp. 23-26 ◽  
Author(s):  
Matthew A. Plow ◽  
Virgil Mathiowetz ◽  
Dawn A. Lowe

Purpose. Compare the efficacy of two interventions designed to promote health and physical activity (PA). Design. This study was a randomized clinical trial using a time series design. Subjects were randomized into individualized physical rehabilitation (IPR) and group wellness intervention (GWI). Primary questionnaires were administered twice preintervention and twice postintervention. Physical fitness and PA frequency were assessed preintervention and postintervention. Setting. Clinic based in a metropolitan area. Subjects. Fifty volunteers with multiple sclerosis. Interventions. IPR consisted of four physical therapy sessions plus three telephone calls. GWI consisted of seven educational sessions. Measures. Primary: SF-36 Health Survey, Modified Fatigue Impact Scale, Mental Health Inventory. Secondary: physical assessment, PA frequency. Analysis. Stability of primary questionnaires between the two pretests was examined. Efficacy of interventions was evaluated by multivariate analysis of variance (MANOVA) and effect sizes. Results. Primary measures were stable between pretests. MANOVA showed nonsignificant differences between interventions. Eight weeks postintervention, both groups had improved PA, fatigue, resting heart rate, and strength. Effect sizes suggested that IPR had a greater effect on preventing decline of physical health, whereas GWI had a greater effect on improving mental health. Conclusion. Preliminary evidence indicated that health and PA improved in both groups. Effect sizes suggested that participants benefited more physically from IPR and more mentally from GWI. Future research should determine whether combining therapeutic exercise with group education improves both mental and physical health.


2004 ◽  
Vol 10 (4) ◽  
pp. 462-468 ◽  
Author(s):  
Alfredo Romani ◽  
Roberto Bergamaschi ◽  
Elisa Candeloro ◽  
Enrico Alfonsi ◽  
Roberto Callieco ◽  
...  

Sixty relapsing-remitting multiple sclerosis (MS) patients were selected on the basis of their score on the Fatigue Severity Scale (FSS) and formed two groups: 40 patients (fatigued MS; MSf) scored above the 75th percentile of a previously assessed representative MS sample (100 patients), and 20 age- and sex-matched patients (nonfatigued MS patients; MSnf) scored below the 25th percentile. The patients underwent clinical evaluation (Expanded Disability Status Scale (EDSS)), further assessment of fatigue (Fatigue Impact Scale), scales evaluating depression (Hamilton Depression Rating Scale (HDRS) and Beck’s Depression Inventory (BDI)) and neuropsychological tests. All patients were evaluated for muscle fatigability and central activation by means of a biomechanical test of sustained contraction; they also underwent somatosensory evoked potentials (SSEPs) and transcranial magnetic stimulation (TMS). The patients of the MSf subgroup were then randomized to one of the following two treatments: 4-aminopyridine (4-AP) 24 mg/day and fluoxetine (FLX) 20 mg/day. After a one-week titration this treatment proceeded for 8 weeks. At the end of the treatment, EDSS, fatigue and depression scores were further evaluated. At baseline, fatigue test scores consistently correlated with depression and cognitive test scores, but not with the fatigability test. Fatigue scores decreased in both treatment groups in a similar way. Due to the design of the study, this cannot be disjoined from a placebo effect. The changes of fatigue scores could not be predicted in the FLX group, whereas in the 4-AP group higher basal fatigability test scores were associated with greater reduction in fatigue scores.


2006 ◽  
Vol 12 (2) ◽  
pp. 227-234 ◽  
Author(s):  
K Rasova ◽  
E Havrdova ◽  
P Brandejsky ◽  
M Zálišová ◽  
B Foubikova ◽  
...  

Purpose The aim of this study was to compare the effect of four different programmes on spiroergometric, spirometric and clinical parameters in multiple sclerosis (MS) patients.Methods One hundred and twelve MS patients were divided into four groups. The first group underwent neurophysiologically based physiotherapy, the second aerobic training, the third combined therapy (neurophysiologically based physiotherapy and aerobic training) and the fourth did not change any habits. Seventeen patients did not finish the study. Patients were examined on impairment (Expanded Disability Status Scale), disability (Barthel Index), handicap (Environment Status Scale), quality of life (Multiple Sclerosis Quality of Life), fatigue (Modified Fatigue Impact Scale), depression (Beck Depression Inventory Score), respiratory function (spirometric parameters on spirometry) and physical fitness (spiroergometric parameters on a bicycle ergometer).Results The patients who participated in one of our training programmes showed a significant improvement of the examined parameters in comparison to those who did not change their present habits. Each of the four training programmes had a different impact on the parameters, which means that each of them had a different effect. The neurophysiologically based physiotherapy had the greatest impact on impairment, and the aerobic training on spirometric and spiroergometric parameters. All methods (the neurophysiologically based physiotherapy, the aerobic training and the combined programme) had an impact on fatigue.


2014 ◽  
Vol 37 (3) ◽  
pp. 271-276 ◽  
Author(s):  
Daphne Bakalidou ◽  
Konstantinos Voumvourakis ◽  
Zoi Tsourti ◽  
Effie Papageorgiou ◽  
Antonios Poulios ◽  
...  

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