Validation of the Parkinson Fatigue Scale in Chinese Parkinson's disease patients

Fatigue, Physical Activity, and Quality of Life in Patients with Inflammatory Bowel Disease: A Cross-Sectional Study

Purpose

The benefits of physical activity (PA) are widely recognized, but the intensity of PA in inflammatory bowel disease (IBD) patients with varying disease activity levels remains controversial. We aimed to investigate the relationship between PA levels, fatigue, and other health-related quality of life (QoL) in Chinese IBD patients.

Patients and Methods

The study is a cross-sectional investigation conducted at a comprehensive IBD diagnosis and treatment facility in East China, spanning from August 2022 to February 2023. A total of 245 participants were initially enrolled, and after excluding individuals with incomplete data about crucial exposure and outcome variables, the final sample size amounted to 237. Participants were provided with a questionnaire encompassing sociodemographic factors, clinical information, the International Physical Activity Questionnaire (IPAQ), the Multidimensional Fatigue Inventory (MFI-20), and the Inflammatory Bowel Disease Questionnaire (IBDQ). Correlation analysis was employed to assess the relationship between variables.

Results

A majority of participants (144) exhibited low levels of PA. Furthermore, 40.5% of all participants reported experiencing fatigue. Individuals with low levels of PA had an average MIF-20 score of 62.9±16.0. Correlation analysis showed that PA was significantly and negatively associated with fatigue (r = -0.224, p < 0.001). Additionally, PA was also negatively correlated with anxiety (r = -0.150, p < 0.05) and depression (r = -0.242, p < 0.001). On the other hand, PA was positively correlated with quality of life (QoL) (r = 0.171, p < 0.01). Furthermore, our analysis indicated that sleep disorders were positively associated with both anxiety (r = 0.349, p < 0.01) and depression (r = 0.354, p < 0.001).

Conclusion

The levels of PA are significantly low, and there is a high prevalence of fatigue among individuals with IBD. PA in IBD showed a strong negative correlation with fatigue and a strong positive correlation with quality of life.

Constructing Prediction Models for Freezing of Gait by Nomogram and Machine Learning: A Longitudinal Study

Objectives: Although risk factors for freezing of gait (FOG) have been reported, there are still few prediction models based on cohorts that predict FOG. This 1-year longitudinal study was aimed to identify the clinical measurements closely linked with FOG in Chinese patients with Parkinson's disease (PD) and construct prediction models based on those clinical measurements using Cox regression and machine learning. Methods: The study enrolled 967 PD patients without FOG in the Hoehn and Yahr (H&Y) stage 1-3 at baseline. The development of FOG during follow-up was the end-point. Neurologists trained in movement disorders collected information from the patients on a PD medication regimen and their clinical characteristics. The cohort was assessed on the same clinical scales, and the baseline characteristics were recorded and compared. After the patients were divided into the training set and test set by the stratified random sampling method, prediction models were constructed using Cox regression and random forests (RF). Results: At the end of the study, 26.4% (255/967) of the patients suffered from FOG. Patients with FOG had significantly longer disease duration, greater age at baseline and H&Y stage, lower proportion in Tremor Dominant (TD) subtype, a higher proportion in wearing-off, levodopa equivalent daily dosage (LEDD), usage of L-Dopa and catechol-O-methyltransferase (COMT) inhibitors, a higher score in scales of Unified Parkinson's Disease Rate Scale (UPDRS), 39-item Parkinson's Disease Questionnaire (PDQ-39), Non-Motor Symptoms Scale (NMSS), Hamilton Depression Rating Scale (HDRS)-17, Parkinson's Fatigue Scale (PFS), rapid eye movement sleep behavior disorder questionnaire-Hong Kong (RBDQ-HK), Epworth Sleepiness Scale (ESS), and a lower score in scales of Parkinson's Disease Sleep Scale (PDSS) (P < 0.05). The risk factors associated with FOG included PD onset not being under the age of 50 years, a lower degree of tremor symptom, impaired activities of daily living (ADL), UPDRS item 30 posture instability, unexplained weight loss, and a higher degree of fatigue. The concordance index (C-index) was 0.68 for the training set (for internal validation) and 0.71 for the test set (for external validation) of the nomogram prediction model, which showed a good predictive ability for patients in different survival times. The RF model also performed well, the C-index was 0.74 for the test set, and the AUC was 0.74. Conclusions: The study found some new risk factors associated with the FOG including a lower degree of tremor symptom, unexplained weight loss, and a higher degree of fatigue through a longitudinal study, and constructed relatively acceptable prediction models.

Tools to assess the quality of life in patients with Parkinson's disease: a systematic review

INTRODUCTION

The clinical, social, and economic implications of Parkinson's disease (PD) are significant; disability occurs leading to a low quality of life (QoL). Information on the QoL of patients with PD and studies on the relationship between QoL and motor and cognitive function are necessary for both research and clinical use to make informed decisions in healthcare and rehabilitation. The aim of this study was to determine which scales are most used to assess QoL in patients with PD.

AREA COVERED

A literature search was conducted in MEDLINE, Scopus, CINAHL, PsycINFO, and Web of Science. Two authors independently identified eligible studies based on predefined inclusion criteria and extracted the data. Study quality and the risk of bias were assessed using the COSMIN checklist.

EXPERT OPINION

116 suitable studies were included, and 42 different instruments were identified. The most frequently used scales were the 39-items and 8-items Parkinson's Disease Questionnaire (PDQ-39) (PDQ-8). These findings suggest further investigation of existing PD outcome measures would benefit patients, researchers, and clinicians. Validated, universal outcome measures are required to allow comparisons across practice; therefore, we recommend that future researchers use a common set of outcome assessments based on the results of this review.

Validation study of the Parkinson's Fatigue Scale in advanced Parkinson's disease

Purpose: To validate the Parkinson’s Fatigue Scale (PFS-16) in advanced Parkinson Disease (APD) patients using the scale’s Spanish version.

Patients and methods: In a clinical study for Levodopa-Carbidopa Intestinal Gel (LCIG), 59 patients were assessed over six months using the PFS-16 and other instruments. The psychometric properties of the PFS-16 were then analyzed.

Results: Patients (60.7% men) were aged 68.02±7.43 years. PD duration was 12.57±5.97 years. Median Hoehn and Yahr (HY) stage of patients in “on” was 2 (range: 1–4). There were excellent data quality and acceptability for the PFS-16 as a whole, except for moderate-to-high ceiling effects in its items. Two factors explained 67% of the variance, yet parallel analysis demonstrated the unidimensional nature of the PFS-16, whose internal consistency was satisfactory (Cronbach’s alpha=0.93; item homogeneity coefficient=0.19, and item total-corrected correlations=0.50–0.84). PFS-16 total score showed moderate-to-high correlations with fatigue-specific questions within clinical tools, namely item 20 of the Beck Depression Inventory (r_S=0.65) and item 4 of the Non-Motor Symptoms Scale (r_S=0.33). Weak-to-moderate correlations were observed between the PFS-16 and measures of anxiety, depression, apathy, and quality of life. There were no significant differences in PFS-16 total scores when grouped by age, sex, time from diagnosis, HY, and CGI-S. After treatment with LCIG, the relative change in PFS-16 total score was −17.6% and the effect size (Cohen’s d) was 0.92. Moderate correlations between changes in the PFS-16 and several other clinical tools were also found.

Conclusion: In APD patients, the PFS-16 showed satisfactory acceptability, internal consistency, construct validity, and responsiveness.

Inherited Ataxia and Intrathecal Baclofen for the Treatment of Spasticity and Painful Spasms

BACKGROUND

Intrathecal baclofen (ITB) treatment is considered a powerful tool in the management of severe spasticity in neurological conditions such as multiple sclerosis, cerebral palsy, and traumatic spinal cord and brain injury.

OBJECTIVES

The objective of this study was to assess the effectiveness of the ITB in patients with inherited ataxia suffering from severe painful spasms and/or spasticity.

METHOD

A total of 5 patients with spinocerebellar ataxia 3 or 7 or Friedreich's ataxia were included in this observational multicenter study. The patients were interviewed and completed outcome measures assessing pain (The Brief Pain Inventory), fatigue (Fatigue Severity Scale), and life satisfaction (LiSAT-9) before and 1 year after the treatment. Spasticity (Modified Ashworth Scale) and spasm frequency (SPFS) were measured objectively for each patient.

RESULTS

The mean treatment time was 1.9 years. Evaluation of established standard forms revealed symptomatic relief from spasticity, spasms, pain, and fatigue in addition to improved body posture, sleep, and life satisfaction after ITB treatment.

CONCLUSIONS

We report the potential beneficial effects of ITB treatment in patients with inherited ataxia who also suffer from spasticity/spasms. ITB treatment indication in neurological disorders allows for extension to the treatment of spasticity/ spasms in patients with hereditary ataxia.

Turkish adaptation of Parkinson fatigue scale and investigating its psychometric properties

Parkinson's disease (PD) is one of the most common chronic degenerative diseases of the nervous system. In PD, nonmotor symptoms are seen as frequently as motor symptoms. Fatigue can occur in all stages of PD and leads to significant disabilities. The aim of this study was to investigate the psychometric properties of the Turkish version of Parkinson fatigue scale (PFS). Ninety-six patients with idiopathic PD were included in this study with a cross-sectional and test-retest design. Structural validity, internal consistency and test-retest reliability of PFS were analyzed. For convergent validity, fatigue severity scale and modified fatigue impact scale were used. Internal consistency was determined by the Cronbach's α coefficient. For test-retest reliability, PFS was repeated after a 7-14-day period. Significant strong correlations were found between the PFS and the fatigue severity scale (rs=0.844) and the modified fatigue impact scale (rs=0.764), which indicate a high convergent validity. The Cronbach's α coefficient, which indicates the internal consistency of the scale, was calculated as 0.947. The test-retest reliability was found to be high (intraclass correlation coefficient=0.928). This study suggests that the Turkish version of PFS is valid and reliable. PFS is suitable for use by researchers and healthcare professionals to assess fatigue in Turkish-speaking patients with PD.

Validation of the Parkinson Fatigue Scale in Chinese Parkinson's disease patients

OBJECTIVE

Fatigue is a common nonmotor symptom in Parkinson's disease (PD); however, the Parkinson's disease fatigue scale (PFS), which is designed to measure fatigue in PD, has not been validated in China. The aim of this study was to determine the validity and reliability of the Chinese version of the PFS in PD patients.

METHODS

A total of 115 PD patients were evaluated at baseline and after 7 days. Assessments included the PFS, the Fatigue Severity Scale (FSS), and scales assessing motor, cognition, depression, and anxiety. Acceptability was assessed in terms of the rate of missing data and floor and ceiling effects. Cronbach's alpha was calculated to determine internal consistency. Test-retest reliability was assessed using the intraclass correlation coefficient (ICC). Spearman's rank correlation coefficients were used to calculate convergent and divergent validity between PFS scores and scales assessing clinical characteristics.

RESULTS

No data were missing for the PFS. Compared with the original scoring method, the binary scoring method had relatively large floor effects (5.21% vs. 17.39%) and ceiling effects (0.90% vs. 4.31%). The internal consistency and test-retest reliability of the PFS were satisfactory (original scoring method: Cronbach's alpha = 0.97, ICC = 0.94; binary scoring method: Cronbach's alpha = 0.94, ICC = 0.94). The PFS score exhibited strong convergent validity with FSS score (correlation coefficient = 0.87). PFS score was weakly to moderately correlated with disease duration and with measures of disease stage, motor function, depression, and anxiety (range of correlation coefficients: 0.25-0.48). There was no significant correlation between PFS score and either onset age or MoCA score (range of correlation coefficients: -0.05 to 0.12).

CONCLUSION

The Chinese version of the PFS is a valid measure for assessing fatigue in PD.