Fatigue Severity Scale (fatigue + severity_scale)

Distribution by Scientific Domains

Selected Abstracts

Fatigue and processing speed are related in multiple sclerosis

A. K. Andreasen
Background:, Fatigue is common in multiple sclerosis (MS) and could be related to impaired processing speed caused by MS specific brain alterations. The objective of this study was to examine the relationship between processing speed and fatigue in patients with relapsing remitting MS. Methods:, Patients with EDSS score ,3.5 were grouped as fatigued [Fatigue Severity Scale (FSS) score ,5.0] or non-fatigued (FSS score ,4.0). Patients with FSS scores ,5 were categorized as primary or secondary fatigued according to various indices. A cognitive test battery obtained from Wechsler's Adult Intelligence Scale-III/Wechsler's Memory Scale-III was applied. Results:, Processing speed (Digit Symbol Coding) was lower amongst all MS patients being 9.4(2.9) in primary fatigued, 8.3(2.8) in secondary fatigued and 10.3(2.7) in non-fatigued versus 12.3(3.0) in healthy controls. In the combined group of primary and secondary fatigued MS patients, processing speed was slower than that in non-fatigued MS patients and inversely related to fatigue (r = ,0.35; P < 0.05). No such relationship could be established in non-fatigued MS patients or in healthy controls. Conclusion:, The degree of fatigue in MS is related to processing speed impairment and longitudinal studies should clarify their mutual dependency. [source]

Measuring fatigue in patients with Parkinson's disease , the Fatigue Severity Scale

K. Herlofson
The objective was to compare the prevalence and severity of fatigue in patients with Parkinson's disease (PD) with that in two control groups, one consisting of randomly chosen control subjects of the same age and sex distribution and the other consisting of patients with coxarthrosis waiting to receive total hip replacement. We also explored the possible correlation of demographic and clinical data to the presence and severity of fatigue. Sixty-six patients with PD, 131 randomly chosen controls and 79 patients with coxarthrosis, waiting to receive total hip replacement, were evaluated for fatigue. Patients and controls with a depressive mood disorder or cognitive impairment had been excluded from the study. Fatigue was measured by the Fatigue Severity Scale (FSS). For the patients with PD the mean total FSS score was 4.1, compared with 2.7 amongst the randomly chosen control group and 2.9 in the group consisting of patients with coxarthrosis. Fifty per cent of the patients with PD had a mean total FSS score of 4 or higher, compared with 25% in both of the two control groups. There was no correlation between pain, presence of self-reported nocturnal sleep disorders or duration of PD and fatigue. The patients with fatigue did have a more advanced disease, measured both by Unified Parkinson's Disease Rating Scale score and Hoehn and Yahr stage. Although the univariate analyses indicated that more severe parkinsonism was correlated to the symptom, the multivariate analysis showed that none of the studied variables were significant explanatory factors for fatigue. Fatigue is a common symptom in patients with PD without depression or dementia. The study indicates that fatigue is an independent symptom of the disease without relation to other motor or non-motor symptoms. [source]

Relationship of health-related quality of life to treatment adherence and sustained response in chronic hepatitis C patients

HEPATOLOGY, Issue 3 2002
David Bernstein
Interferon therapy may exacerbate health-related quality of life (HRQL) deficits associated with hepatitis C virus (HCV) early in the course of therapy. Treatment with polyethylene glycol,modified interferon (peginterferon) alfa-2a (40 kd) provides improved sustained response over interferon alfa-2a, but its effect on HRQL is unknown. The objective of this study was to (1) evaluate the effect of sustained virologic response on HRQL in patients with HCV and (2) determine whether impairment of HRQL during treatment contributes to early treatment discontinuation. Data consisted of a pooled secondary analysis of patients (n = 1,441) across 3 international, multicenter, open-label, randomized studies that compared peginterferon alfa-2a (40 kd) with interferon alfa-2a. ANCOVA was used to examine the effect of sustained virologic response on HRQL. Repeated-measures mixed-models ANCOVA was used to compare Fatigue Severity Scale (FSS) and SF-36 scores during treatment by treatment group. Logistic regression analysis was used to examine the association between changes at baseline in on-treatment HRQL and early treatment discontinuation. Sustained virologic response was associated with marked improvements from baseline to end of follow-up in all subjects, including patients with cirrhosis. During treatment, patients receiving peginterferon alfa-2a (40 kd) had statistically significantly better scores on both the SF-36 and FSS. Baseline to 24-week changes in fatigue and SF-36 mental and physical summary scores significantly predicted treatment discontinuation. In conclusion, sustained virologic response is associated with improvements in quality of life in patients with or without advanced liver disease. This parameter may be an important consideration in maximizing treatment adherence. [source]

Modafinil treatment of fatigue in patients with ALS: A placebo-controlled study

MUSCLE AND NERVE, Issue 3 2009
Judith G. Rabkin PhD
Abstract Our objective was to determine whether modafinil alleviates fatigue in patients with amyotrophic lateral sclerosis (ALS). A placebo controlled trial with a 3:1 modafinil:placebo randomization in doses up to 300 mg/day for 4 weeks was followed by 8 weeks of open maintenance treatment. The primary endpoint was the Clinical Global Impressions-Improvement Scale. Secondary endpoints were the Fatigue Severity Scale, Epworth Sleepiness Scale, Beck Depression Inventory, Role Function Scale, and visual analog scales. Analysis of covariance was used to assess change at Week 4. Thirty-two patients were randomized; 29 completed the 4-week trial. In intention to treat (ITT) analysis, the response was 76% for modafinil versus 14% for placebo. In a completer analysis, the modafinil response rate was 86%, and the placebo response rate remained 14%. The number needed to treat was 1.6 (ITT). No medically serious adverse events were reported. Modafinil may be a promising intervention for fatigue in ALS patients. Replication in a larger study is needed. Muscle Nerve 39: 297,303, 2009 [source]

Factors influencing quality of life in multiple sclerosis patients: disability, depressive mood, fatigue and sleep quality

I. S. Lobentanz
Objectives , In a series of 504 patients with multiple sclerosis (MS), quality of life (QOL) and its main clinical and demographic determinants were assessed in comparison with healthy individuals. Materials and methods , A postal questionnaire with self-completed measures of disability (Expanded Disability Status Scale, EDSS), QOL (Quality of Life Index, QLI), depressive mood (Self-rating Depression Scale, SDS), fatigue severity (Fatigue Severity Scale, FSS) and sleep quality (Pittsburgh Sleep Quality Index, PSQI) was sent to this sample of MS patients. Results , Most patients were severely disabled; almost half were mildly to severely depressed, suffering from reduced sleep quality and/or fatigue. The multiple sclerosis patients had significantly lower QLI scores than healthy controls. EDSS and SDS scores were found to be predictors of global QLI score. Regarding the different QLI domains, mean SDS scores remained predictive for all QLI items, while mean EDSS, PSQI and FSS scores were only predictive for physical domains. Conclusion , Our study clearly demonstrates that depressive mood is the main factor influencing QOL. The disability status, fatigue and reduced sleep quality have an impact mainly on physical domains of life quality. [source]

Fatigue rating scales critique and recommendations by the Movement Disorders Society task force on rating scales for Parkinson's disease,

Joseph H. Friedman MD
Abstract Fatigue has been shown to be a consistent and common problem in Parkinson's disease (PD) in multiple countries and cultures. It is one of the most disabling of all symptoms, including motor dysfunction, and appears early, often predating the onset of motor symptoms. Several studies of the epidemiology of fatigue have been published, often using different scales, but few on treatment. The Movement Disorder Society (MDS) commissioned a task force to assess available clinical rating scales, critique their psychometric properties, summarize their clinical properties, and evaluate the evidence in support of their use in clinical studies in PD. Six clinical researchers reviewed all studies published in peer reviewed journals of fatigue in PD, evaluated the scales' previous use, performance parameters, and quality of validation data, if available. Scales were rated according to criteria provided by the MDS. A scale was "recommended" if it has been used in clinical studies beyond the group that developed it, has been used in PD and psychometric studies have established that it is a valid, reliable and sensitive to change in people with PD. Requiring a scale to have demonstrated sensitivity to change in PD specifically rather than in other areas in order to attain a rating of "recommended" differs from the use of this term in previous MDS task force scale reviews. "Suggested" scales failed to meet all the criteria of a "recommended" scale, usually the criterion of sensitivity to change in a study of PD. Scales were "listed" if they had been used in PD studies but had little or no psychometric data to assess. Some scales could be used both to screen for fatigue as well as to assess fatigue severity, but some were only used to assess severity. The Fatigue Severity Scale was "recommended" for both screening and severity rating. The Fatigue Assessment Inventory, an expanded version of the Fatigue severity Scale, is "suggested" for both screening and severity. The Functional Assessment of Chronic Illness Therapy-Fatigue was "recommended" for screening and "suggested" for severity. The Multidimensional Fatigue Inventory was "suggested" for screening and "recommended" for severity. The Parkinson Fatigue Scale was "recommended" for screening and "suggested" for severity rating. The Fatigue Severity Inventory was "listed" for both screening and severity. The Fatigue Impact Scale for Daily Use, an adaptation of the Fatigue Impact Scale was "listed" for screening and "suggested" for severity. Visual Analogue and Global Impression Scales are both "listed" for screening and severity. The committee concluded that current scales are adequate for fatigue studies in PD but that studies on sensitivity and specificity of the scales are still needed. © 2010 Movement Disorder Society [source]

Improving fatigue assessment in immune-mediated neuropathies: the modified Rasch-built fatigue severity scale

Sonja I. Van Nes
Abstract Fatigue is a major disabling complaint in patients with immune-mediated neuropathies (IN). The 9-item fatigue severity scale (FSS) has been used to assess fatigue in these conditions, despite having limitations due to its classic ordinal construct. The aim was to improve fatigue assessment in IN through evaluation of the FSS using a modern clinimetric approach [Rasch unidimensional measurement model (RUMM2020)]. Included were 192 stable patients with Guillain-Barré syndrome (GBS), chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) or polyneuropathy associated with monoclonal gammopathy of undetermined significance (MGUSP). The obtained FSS data were exposed to RUMM2020 model to investigate whether this scale would meet its expectations. Also, reliability and validity studies were performed. The original FSS did not meet the Rasch model expectations, primarily based on two misfitting items, one of these also showing bias towards the factor ,walking independent.' After removing these two items and collapsing the original 7-point Likert options to 4-point response categories for the remaining items, we succeeded in constructing a 7-item Rasch-built scale that fulfilled all requirements of unidimensionality, linearity, and rating scale model. Good reliability and validity were also obtained for the modified FSS scale. In conclusion, a 7-item linearly weighted Rasch-built modified FSS is presented for more proper assessment of fatigue in future studies in patients with immune-mediated neuropathies. [source]