Is Symptomatic Fatigue Associated With Physical Activity and Sedentary Behaviors Among Persons With Multiple Sclerosis?

Abstract

Background. Fatigue is a debilitating symptom in multiple sclerosis (MS) that may be associated with reduced physical activity and increased sedentary behavior. Objective. This study examined the associations among fatigue and device-measured physical activity and sedentary behavior in people with MS. Methods. The participants (n = 252) completed the Patient Determined Disease Steps (PDDS) and Fatigue Severity Scale (FSS) and wore a waist-mounted accelerometer for 7 days. Participants were divided into 2 groups based on fatigue severity as measured by the FSS scale. We compared percentage of wear time spent in sedentary, light physical activity (LPA), and moderate to vigorous physical activity (MVPA) between the 2 groups. Results. Persons in the fatigued group (FSS score ≥ 4) spent a greater percentage of time in sedentary behavior ( P = .004) and a lower percentage of time in LPA ( P = .035). Persons in the fatigued group further spent a lower percentage of time in nontransformed MVPA ( P < .001) and square-root-transformed MVPA ( P < .001) than persons in the nonfatigued group. When controlling for PDDS scores and years of education, there were no longer significant differences between groups in sedentary behavior, LPA, or transformed MVPA values; the difference in nontransformed MVPA was still statistically significant but likely the result of nonnormally distributed data. Conclusion. The present study suggests that factors other than fatigue might be associated with physical activity and sedentary behavior in MS, and this group might benefit from focal behavioral interventions that take into account mobility status in persons with MS who have fatigue.

Does Multiple Sclerosis Differently Impact Physical Activity in Women and Man? A Quantitative Study Based on Wearable Accelerometers

“…In terms of PA intensity, the percentages of SB (63 to 68% for men and women respectively) and LPA (20 to 27%) here calculated, were found fully consistent with those reported in previous studies which indicated values from 60 to 70% for SB and 27 to 37% for LPA [16,[42][43][44]55]. In contrast, the percentage of time spent in MVPA (approximately 10%), was found slightly higher than what usually observed for pwMS (1-7%).…”

“…Although the level of disability and duration of the disease were similar across men and women of our sample, it is to be considered that men usually take less time than women to reach the same impairment level, and thus that the trajectory of change in attitude to performing PA may be different for the two sexes. In this context, the results which refer to sedentariness should be further verified in future studies performed on larger cohorts, as there are factors (like for example fatigue, but also the presence of specific disabilities which affects mobility [55]) that are likely to change with the duration of the disease, thus also modifying the propensity to perform PA.…”

A pilot study of the moderating effect of gender on the physical activity and fatigue severity among recovered COVID-19 patients

“…Although there is a body of knowledge on the association between fatigue and PA, the complex relationship between these factors and gender is limited. Moreover, although there is little known about the relationship between fatigue and PA levels in patients who have recovered from COVID-19, studies have revealed the nature of this relationship in several disease populations [19][20][21]. Clinical data regarding COVID-19 point towards gender-based differences in COVID-19 severity [22].…”

The Role of Remote Monitoring in Evaluating Fatigue in Multiple Sclerosis: A Review

“…In MS, studies evaluating physical activity using commercial wearables have shown (1) strong-moderate correlations between clinical and patient-reported disability measures ( 6 , 74 – 80 ), (2) continuous observation provides less biased assessment vs. sporadic cross-sectional measures ( 6 , 74 , 81 , 82 ), (3) fatigue is not the only factor affecting sedentary behavior and physical activity in MS ( 83 , 84 ) and (4) that average daily step count (STEPS) is responsive to change over 1-year, even when conventional measures remain stable ( 74 ).…”