Can fatigue predict the worsening of multiple sclerosis one year later? An explorative study with participants referred to assess their ability to work (original) (raw)
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Multiple sclerosis and related disorders, 2017
Background: Our objective was to validate the Danish translation of the Fatigue Scale for Motor and Cognitive Functions (FSMC) in multiple sclerosis (MS) patients. Materials and methods: A Danish MS cohort (n = 84) was matched and compared to the original German validation cohort (n = 309) and a healthy control cohort (n = 147). The Modified Fatigue Impact Scale (MFIS) was used as reference scale and Becks Depression Inventory-Fast Screen (BDI-FS) and Expanded Disability Status Scale (EDSS) for confounding factors. We assessed internal consistencies; convergent, divergent, and predictive validity; partial correlations correcting for depression; significant differences between the mean scores of the cohorts; and sensitivity and specificity with receiver operating characteristic (ROC) curves. Results: Excellent internal consistencies for the total scale and subscales were found (α = 0.91-0.95). Strong positive correlations between the two fatigue scales implied high convergent validity (total scores: r = 0.851, p < 0.01). The two cohorts corresponded well when divided into subgroups (EDSS score; age; gender). Correcting for depression did not result in any significant adjustments of the correlations. The area under the curve (AUC) for the ROC curves represented excellent accuracy (Danish MS cohort, AUC = 0.9190; German MS cohort, AUC = 0.9034). Conclusion: The Danish translation of the FSMC has a high convergent validity with another measure of fatigue as well as excellent internal consistency and accuracy. It is found to be an applicable and recommendable measure of fatigue in Danish MS patients.
The American Journal of Occupational Therapy, 2003
OBJECTIVE. The test–retest reliability and the convergent validity of the Fatigue Impact Scale (FIS) were evaluated using secondary data from 54 persons with multiple sclerosis (MS). METHODS. This reliability and validity study used FIS data from before and after two control periods to evaluate test–retest reliability. Convergent validity of the FIS with the Fatigue Severity Scale and with subscales of the SF-36 Health Survey was evaluated using data collected before the first control period. RESULTS. No significant differences between before and after FIS measurements and intraclass correlation coefficients ranging from .68 to .85 indicate that the FIS has good test–retest reliability except for the physical subscale. The expected moderate correlations between the FIS and several subscales of the SF-36 support its convergent validity. In contrast, the unexpected low correlation between the FIS and Fatigue Severity Scale does not support convergent validity. CONCLUSION. The FIS has ...
A longitudinal study of variations in and predictors of fatigue in multiple sclerosis
Journal of Neurology, Neurosurgery & Psychiatry, 2008
Objectives: To describe variations in fatigue over the course of 2 years in a sample of persons with multiple sclerosis (MS), and to investigate the predictive value of the following variables on variations in fatigue: sex, age, sense of coherence, living with a partner, living with children, work status, immunomodulatory treatment, mood, disease severity, disease course, time since diagnosis and time. Methods: Every 6 months, 219 outpatients at an MS specialist clinic were assessed using the Fatigue Severity Scale (FSS). Predictive values were explored with Generalised Estimating Equation employing proportional odds models; FSS scores were categorised as nonfatigue, borderline fatigue or fatigue. Results: FSS scores varied significantly (p = 0.02); 54% changed FSS category one or several times, 27% were persistently fatigued and 19% persistently non-fatigued. Independent predictors of increased fatigue were depressive symptoms, weak/moderate sense of coherence, living with a partner and not working. Furthermore, moderate disease severity predicted increase when combined with .10 years since diagnosis or a progressive course. Independent predictors of decreased fatigue were no depressive symptoms, strong sense of coherence, living alone and working. Moreover, mild and severe disease predicted a decrease when combined with .10 years since diagnosis, and mild severity combined with a progressive course. Conclusion: Mood, sense of coherence and living with a partner were independent predictors of fatigue in persons with MS. In addition to monitoring disease related variables, health related services should apply a broad range of approaches and repeatedly assess fatigue in persons with MS, to provide preventive care and appropriate interventions.
A rapid screening tool for fatigue impact in multiple sclerosis
Bmc Neurology, 2006
Background: Fatigue is a common complaint in multiple sclerosis (MS) and often interferes with daily functioning. Both clinicians and researchers may need to detect high levels of fatigue impact using a time and effort efficient tool. This study evaluates the psychometric properties of a rapid screening instrument for fatigue impact in multiple sclerosis.
Assessing fatigue in multiple sclerosis: Dutch modified fatigue impact scale
Acta neurologica Belgica, 2003
The aim of this study is to evaluate the reliability, validity and responsiveness of the Dutch version of the Modified Fatigue Impact Scale. Fifty-one randomly selected subjects with definite multiple sclerosis (MS) (mean age 51.9 +/- 10.5 years, 25 women) and 20 healthy controls (mean age 50.6 +/- 14.0 years, 13 women) filled in the Modified Fatigue Impact Scale (MFIS), the Fatigue Severity Scale (FSS) and the fatigue subscale of Guy's Neurological Disability Scale (GNDS). All tests were repeated with an interval of maximum three days. The hospitalised individuals with MS (n = 20) were assessed at intake and discharge. No significant difference was found between first and second administration of MFIS (z = -.519, p = .603, Wilcoxon signed ranks test), with a good correlation (.729). MFIS was able to distinguish individuals with MS from controls, and subjects with fatigue from the non-fatigued group. MFIS showed no floor or ceiling effect. MFIS correlated moderately with Fatigue...
Journal of Neurology, 2019
Fatigue is among the most disabling symptoms in patients with multiple sclerosis (PwMS). The common distinction between cognitive and motor fatigue is typically incorporated in self-rating instruments, such as the Chalder Fatigue Questionnaire (CFQ), the Fatigue Scale for Motor and Cognitive Functions (FSMC) or the Modified Fatigue Impact Scale (MFIS). The present study investigated the factor structure of the CFQ, the FSMC and the MFIS utilizing exploratory (EFA) and confirmatory factor analysis (CFA) as well as exploratory structural equation modeling (ESEM). Data of 1.403 PwMS were analyzed, utilizing four samples. The first sample (N = 605) was assessed online and split into two stratified halves to perform EFA, CFA, and ESEM on the CFQ and FSMC. The second sample (N = 293) was another online sample. It served to calculate CFA and ESEM on the CFQ and FSMC. The third sample was gathered in a clinical setting (N = 196) and analyzed by applying CFA and ESEM to the FSMC. The fourth sample (N = 309) was assessed in a clinical setting and allowed to run a CFA and ESEM on the MFIS. Proposed factor structures of all questionnaires were largely confirmed in EFA. However, none of the calculated CFAs and ESEMs could verify the proposed factor structures of the three measures, even with oblique rotation techniques. The findings might have implications for future research into the pathophysiological basis of MS-related fatigue and could affect the suitability of such measures as outcomes for treatment trials, presumably targeting specific sub-components of fatigue.
Health and Quality of Life Outcomes, 2010
Background: Fatigue is a common and debilitating symptom in multiple sclerosis (MS). Best-practice guidelines suggest that health services should repeatedly assess fatigue in persons with MS. Several fatigue scales are available but concern has been expressed about their validity. The objective of this study was to examine the reliability and validity of a new scale for MS fatigue, the Neurological Fatigue Index (NFI-MS). Methods: Qualitative analysis of 40 MS patient interviews had previously contributed to a coherent definition of fatigue, and a potential 52 item set representing the salient themes. A draft questionnaire was mailed out to 1223 people with MS, and the resulting data subjected to both factor and Rasch analysis.