Karpatkin H, Babyar S, DiCarrado S, McDarby M, Narovlianski M, Perez B, Rimawi I. Increases in fatigue do not change spasticity scores in persons with multiple sclerosis.
Neurodegener Dis Manag 2018;
8:143-150. [PMID:
29943692 DOI:
10.2217/nmt-2017-0049]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
AIM
Fatigue is a common finding in multiple sclerosis (MS) which may result in worsening of gait, function and other MS symptoms, like spasticity. Although the worsening of spasticity with fatigue has been reported by persons with MS, the effect of fatigue on spasticity has not been measured.
PURPOSE
The purpose of this study was to compare lower extremity Modified Ashworth Scale (MAS) scores of persons with mild-to-moderate MS symptoms before and after fatigued and unfatigued conditions.
METHODS
Using a randomized crossover design, MS subjects underwent 6-min walk to induce fatigue and 6-min supine rests, with lower extremity spasticity measured before and after each condition. Friedman tests gave paired comparisons of MAS before and after each condition.
RESULTS
16 subjects with mild-to-moderate MS completed the study (mean age = 56; standard deviation = 11.7). Friedman tests showed a significant decrease in mean rank for overall average MAS for both lower extremities (p = 0.031) when comparing fatigued to unfatigued conditions. This appeared to be driven by the right lower extremity average MAS (p = 0.002) and, more specifically, in post hoc pre to post-test comparisons for right knee flexor (p = 0.002 fatigued; p = 0.059 unfatigued) and right knee extensor (p = 0.001 fatigued; p = 0.020 unfatigued) MAS mean rank differences. Fatigue did not result in increased spasticity.
CONCLUSION
Spasticity in these subjects with MS was not worsened by fatigue suggesting that worsening of gait with fatigue may be due to causes other than spasticity.
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