Psychometric properties of the Fatigue Severity Scale and the Modified Fatigue Impact Scale

Learmonth, Yvonne C.; Dlugonski, Deirdre; Pilutti, Lara A.; Sandroff, Brian M.; Klaren, Rachel E.; Motl, Robert W.

doi:10.1016/j.jns.2013.05.023

Cited by 248 publications

(202 citation statements)

References 47 publications

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“…Perceived fatigue may be variable both within (55) and between (56) days in people with MS. Of the most common measures from studies included in this meta-analysis, the MFIS asks “how much of a problem fatigue has caused them during the past month, including the day of testing” (15). The FSS is not anchored by a time period and instead asks for “agreement” with items regarding fatigue (14), although it is sometimes “based on the previous week” (57). Circadian variation in physical performance (58) may influence the fatigability tasks.…”

Section: Discussionmentioning

confidence: 99%

Relationship between perceived fatigue and performance fatigability in people with multiple sclerosis: A systematic review and meta-analysis

Loy

Taylor

Fling

et al. 2017

Journal of Psychosomatic Research

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Objective Perceived fatigue (i.e., subjective perception of reduced capacity) is one of the most common and disabling symptoms for people with multiple sclerosis (MS). Perceived fatigue may also be related to performance fatigability (i.e., decline in physical performance over time), although study findings have been inconsistent. Objective To locate all studies reporting the relationship between perceived fatigue and fatigability in people with MS, determine the population correlation, and examine moderating variables of the correlation size. Methods In accordance with PRISMA guidelines, systematic searches were completed in Medline, PsychInfo, Google Scholar, and the Cochrane Library for peer-reviewed articles published between March 1983 and August 2016. Included articles measured perceived fatigue and performance fatigability in people with MS and provided a correlation between measures. Moderator variables expected to influence the relationship were also coded. Searches located 19 studies of 848 people with MS and a random-effects model was used to pool correlations. Results The mean correlation between fatigue and fatigability was positive, “medium” in magnitude, and statistically significant, r = 0.31 (95% CI = 0.21, 0.42), p < .001. Despite moderate between-study heterogeneity (I2 = 46%) no statistically significant moderators were found, perhaps due to the small number of studies per moderator category. Conclusion There is a significant relationship between perceived fatigue and fatigability in MS, such that people reporting elevated fatigue also are highly fatigable. The size of the relationship is not large enough to suggest fatigue and fatigability are the same construct, and both should continue to be assessed independently.

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Section: Discussionmentioning

confidence: 99%

Relationship between perceived fatigue and performance fatigability in people with multiple sclerosis: A systematic review and meta-analysis

Loy

Taylor

Fling

et al. 2017

Journal of Psychosomatic Research

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“…A higher score indicates a higher impact of fatigue. Learmonth et al [28] reported acceptable reliability of the FSS over six months (ICC = 0.751).…”

Section: Methodsmentioning

confidence: 99%

Habitual Functional Electrical Stimulation Therapy Improves Gait Kinematics and Walking Performance, but Not Patient-Reported Functional Outcomes, of People with Multiple Sclerosis who Present with Foot-Drop

et al. 2014

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BackgroundPeople with Multiple Sclerosis (pwMS) often experience a disturbed gait function such as foot-drop. The objective of this pilot study was to investigate the medium term effects of using Functional Electrical Stimulation (FES) to treat foot-drop over a period 12 weeks on gait and patient reported outcomes of pwMS.Methods and FindingsNine pwMS aged 35 to 64 (2 males, 7 females) were assessed on four occasions; four weeks before baseline, at baseline and after six weeks and twelve weeks of FES use. Joint kinematics and performance on the 10 meter and 2 minute walk tests (10WT, 2 minWT) were assessed with and without FES. Participants also completed the MS walking Scale (MSWS), MS impact scale (MSIS29), Fatigue Severity Score (FSS) and wore an activity monitor for seven days after each assessment. Compared to unassisted walking, FES resulted in statistically significant improvements in peak dorsiflexion in swing (p = 0.006), 10MWT (p = 0.006) and 2 minWT (p = 0.002). Effect sizes for the training effect, defined as the change from unassisted walking at baseline to that at 12 weeks, indicated improved ankle angle at initial contact (2.6°, 95% CI −1° to 4°, d = 0.78), and a decrease in perceived exertion over the 2 min walking tests (−1.2 points, 95% CI −5.7 to 3.4, d = −0.86). Five participants exceeded the Minimally Detectable Change (MDC) for a training effect on the 10mWT, but only two did so for the 2 minWT. No effects of the use of FES for 12 weeks were found for MSWS, MSIS29, FSS or step count.ConclusionAlthough FES to treat foot-drop appears to offer the potential for a medium term training effect on ankle kinematics and walking speed, this was not reflected in the patient reported outcomes. This observed lack of relationship between objective walking performance and patient reported outcomes warrants further investigation.Trial RegistrationClinicalTrials.gov NCT01977287

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“…Both the FSS and MFIS demonstrate adequate reliability in MS patients. 13 Self-reported fatigue correlates with depression, 1 likely due to over-reporting of fatigue symptoms by patients with lower mood. As such, we also administered the Beck Depression Inventory, Second Edition (BDI-II) to control for the mood-related aspect of self-reported fatigue.…”

Section: Methodsmentioning

confidence: 99%

Body Temperature Is Elevated and Linked to Fatigue in Relapsing-Remitting Multiple Sclerosis, Even Without Heat Exposure

Sumowski

Leavitt²

2014

Archives of Physical Medicine and Rehabilitation

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Objective To investigate whether resting body temperature is elevated and linked to fatigue in patients with relapsing-remitting multiple sclerosis (RRMS). Design Cross-sectional study investigating (a) differences in resting body temperature across RRMS, SPMS, and healthy groups, and (b) the relationship between body temperature and fatigue in RRMS patients. Setting Climate-controlled laboratory (~22°C) within a non-profit medical rehabilitation research center. Participants Fifty patients with RRMS, 40 matched healthy controls, and 22 patients with secondary-progressive MS (SPMS). Intervention None. Main Outcome Measure(s) Body temperature was measured with an aural infrared thermometer (normal body temperature for this thermometer is 36.75°C), and differences were compared across RRMS, SPMS, and healthy persons. RRMS patients completed measures of general fatigue (Fatigue Severity Scale; FSS), as well as physical and cognitive fatigue (Modified Fatigue Impact Scale; MFIS). Results There was a large effect of group (p<.001, ηp2=.132) whereby body temperature was higher in RRMS patients (37.04°C±0.27) relative to healthy controls (36.83 ± 0.33; p = .009) and SPMS patients (36.75°C±0.39; p=.001). Warmer body temperature in RRMS patients was associated with worse general fatigue (FSS; rp=.315, p=.028) and physical fatigue (pMFIS; rp=.318, p=.026), but not cognitive fatigue (cMIFS; rp=−.017, p=.909). Conclusions These are the first-ever demonstrations that body temperature is elevated endogenously in RRMS patients, and linked to worse fatigue. We discuss these findings in the context of failed treatments for fatigue in RRMS, including several failed randomized controlled trials (RCTs) of stimulants (modafinil). In contrast, our findings may help explain how RCTs of cooling garments and antipyretics (aspirin) have effectively reduced MS fatigue, and encourage further research on cooling/antipyretic treatments of fatigue in RRMS.

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Psychometric properties of the Fatigue Severity Scale and the Modified Fatigue Impact Scale

Cited by 248 publications

References 47 publications

Relationship between perceived fatigue and performance fatigability in people with multiple sclerosis: A systematic review and meta-analysis

Relationship between perceived fatigue and performance fatigability in people with multiple sclerosis: A systematic review and meta-analysis

Habitual Functional Electrical Stimulation Therapy Improves Gait Kinematics and Walking Performance, but Not Patient-Reported Functional Outcomes, of People with Multiple Sclerosis who Present with Foot-Drop

Body Temperature Is Elevated and Linked to Fatigue in Relapsing-Remitting Multiple Sclerosis, Even Without Heat Exposure

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