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Cohen ET, Matsuda PN, Fritz NE, Allen DD, Yorke AM, Widener GL, Jewell ST, Potter K. Self-Report Measures of Fatigue for People With Multiple Sclerosis: A Systematic Review. J Neurol Phys Ther 2024; 48:6-14. [PMID: 37406155 DOI: 10.1097/npt.0000000000000452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
BACKGROUND AND PURPOSE The symptom of fatigue impairs function in people with multiple sclerosis (MS). Choosing appropriate measures to assess fatigue is challenging. The purpose of this article is to report the findings of a systematic review of patient-reported fatigue measures for people with MS. METHODS PubMed, CINAHL, and Embase databases were searched through January 2020 using terms related to fatigue and MS. Studies were included if the sample size was 30 or more or smaller samples if adequately powered, and if information about measurement characteristics (ie, test-retest reliability, content validity, responsiveness, interpretability, or generalizability) of the measure(s) could be extracted. Study quality was appraised with the 2-point COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. Data about measurement characteristics, psychometrics, and clinical utility were extracted and results were synthesized. RESULTS Twenty-four articles met inclusion criteria with information about 17 patient-reported fatigue measures. No studies had critical methodologic flaws. Measurement characteristic data were not available for all measures. Clinical utility varied in time to complete and fatigue domains assessed. DISCUSSION AND CONCLUSIONS Five measures had data pertaining to all properties of interest. Of these, only the Modified Fatigue Impact Scale (MFIS) and Fatigue Severity Scale (FSS) had excellent reliability, responsiveness data, no notable ceiling/floor effects, and high clinical utility. We recommend the MFIS for comprehensive measurement and the FSS for screening of subjective fatigue in people with MS.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A443 ).
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Affiliation(s)
- Evan T Cohen
- Arcadia University, Glenside, Pennsylvania (E.T.C.); University of Washington, Seattle (P.N.M.); Departments of Health Care Sciences and Neurology, Wayne State University, Detroit, Michigan (N.E.F.); University of California San Francisco/San Francisco State University, San Francisco (D.D.A.); University of Michigan-Flint, Flint (A.M.Y.); Samuel Merritt University, Oakland, California (G.L.W.); Rutgers University Libraries, New Brunswick, New Jersey (S.T.J.); and Tufts University, Seattle, Washington, (K.P.)
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Mitsikostas D, Bakirtzis C, Nikolaidis I, Tsimourtou V, Kountra P, Matsi S, Papadimitriou A. Quality of life in people with multiple sclerosis receiving glatiramer acetate or interferon in Greek clinical practice. Neurodegener Dis Manag 2022; 12:311-322. [PMID: 36178000 DOI: 10.2217/nmt-2022-0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: To evaluate glatiramer acetate (GA) or IFN-β effects on quality of life (QoL) in people with relapsing/remitting multiple sclerosis (PwRRMS) in Greece. Methods: A prospective, practice-based study. QoL/function/symptoms were assessed by seven questionnaires/scales. Results: Significant increases in Short Form-36 (SF-36) health survey scores occurred with GA in four of the eight domains and three of the eight domains at 6 and 12 months, respectively, versus baseline. Similar and significant SF-36 score improvements occurred with GA in treatment-naive PwRRMS. SF-36 scores were unaffected in GA-treated, IFN-β treatment-experienced PwRRMS, or with IFN-β versus baseline. Slight improvements in fatigue and sexual satisfaction were evident (6 months). No deteriorations were seen in the other four instruments. Conclusion: The findings show that 12-month treatment with GA, but not IFN-β, improved certain QoL parameters in treatment-naive PwRRMS.
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Affiliation(s)
- Dimos Mitsikostas
- First Department of Neurology, Aeginition Hospital, National & Kapodistrian University of Athens, Athens, 11528, Greece
| | - Christos Bakirtzis
- Multiple Sclerosis Center, 2nd Department of Neurology, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, 54636, Greece
| | - Ioannis Nikolaidis
- Multiple Sclerosis Center, 2nd Department of Neurology, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, 54636, Greece
| | - Vana Tsimourtou
- Department of Neurology, University General Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, 40500, Greece
| | - Persa Kountra
- Department of Neurology, General Hospital of Volos, Volos, 38222, Greece
| | - Stavroula Matsi
- Country Medical Affairs Manager, Teva Pharmaceuticals, Athens, 15135, Greece
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Broche-Pérez Y, Jiménez-Morales RM, Monasterio-Ramos LO, Vázquez-Gómez LA, Fernández-Fleites Z. Fear of Relapse Scale: Spanish version and psychometric characteristics in a sample of patients with Relapsing-Remitting multiple sclerosis. Neurologia 2022:S2173-5808(22)00080-3. [PMID: 35907628 DOI: 10.1016/j.nrleng.2022.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 06/28/2022] [Indexed: 10/16/2022] Open
Abstract
INTRODUCTION Relapses are a hallmark of multiple sclerosis, being a characteristic feature of relapsing-remitting multiple sclerosis (RRMS). The occurrence of a relapse constitutes a source of significant discomfort that impacts all domains of daily life of patients with multiple sclerosis (PwMS). In this study we first explored the psychometric properties of the Spanish version of the Fear of Relapse Scale (FoR) in a sample of patients with RRMS. Besides, we explored the relationship between the Fear of Relapse Scale with fatigue and cognitive perceived deficits in our PwMS sample. METHODS An online cross-sectional survey was conducted on 173 MS patients from 12 Spanish-speaking countries (Argentina, Mexico, Uruguay, Dominican Republic, Spain, Cuba, Colombia, Guatemala, Chile, Paraguay, Peru, and El Salvador). Confirmatory factor analysis (CFA) was performed to assess the factor structure of the scale. Multiple linear regression was used to evaluate the effects of health self-perception, fatigue, and perceived cognitive deficits over fear of relapse. RESULTS The three-factor model in the CFA yielded a good model fit (χ2/df = 2.25, P < .001, RMSEA = .078, CFI = .91). McDonalds' Omega of the FoR (Spanish version) was .91. There was a statistically significant inverse correlation between FoR and health self-perception, and a positive correlation between FoR, fatigue, and perceived cognitive deficits. Finally, level of fatigue was a predictor of fear of relapse. CONCLUSIONS The Spanish version of the Fear of Relapse Scale is a valid and reliable instrument to explore the experience of fear of relapse in patients with RRMS.
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Affiliation(s)
- Y Broche-Pérez
- Psychology Department, Universidad Central "Marta Abreu" de Las Villas, Santa Clara, Cuba; CognitiON (Cuban Inicative on Cognitive Health), Santa Clara, Cuba.
| | | | | | - L A Vázquez-Gómez
- Department of Neurology, Hospital Provincial Universitario Arnaldo Milián Castro, Santa Clara, Cuba
| | - Z Fernández-Fleites
- Psychology Department, Universidad Central "Marta Abreu" de Las Villas, Santa Clara, Cuba; CognitiON (Cuban Inicative on Cognitive Health), Santa Clara, Cuba
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Prolonged visual evoked potential latency predicts longitudinal worsening of fatigue in people with multiple sclerosis. Mult Scler Relat Disord 2022; 67:104073. [DOI: 10.1016/j.msard.2022.104073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 06/25/2022] [Accepted: 07/24/2022] [Indexed: 11/19/2022]
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Huang MH, Doyle L, Burnham A, Fry DK, Shea K. Predictors of positive outcomes following resistive inspiratory muscle training in non-ambulatory persons with advanced multiple sclerosis. Mult Scler J Exp Transl Clin 2022; 8:20552173211058862. [PMID: 35634011 PMCID: PMC9134439 DOI: 10.1177/20552173211058862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 10/22/2021] [Indexed: 11/17/2022] Open
Abstract
Background Inspiratory muscle training (IMT) using a threshold device improves
inspiratory muscle strength. What factors influence the IMT outcome has not
been examined. Objective To identify predictors of the positive outcome following IMT in persons with
advanced multiple sclerosis (PwAMS). Methods Inclusion criteria were non-ambulatory PwAMS, Expanded Disability Status
Scale (EDSS) ≥6.5, age >18 years, no acute medical conditions, current
non-smokers, and ability to consent. Participants (n = 38)
performed daily inspiratory exercises using a resistive threshold device for
10 weeks. Baseline measurements included age, sex, body mass index, year
post multiple sclerosis diagnosis, comorbidities, EDSS, Modified Fatigue
Impact Scale-5, and oral Symbol Digit Modality Test. The percentage of
completed prescribed exercise trials (Trials%) during the 10-week
intervention was calculated. Age- and sex-adjusted predicted values of
maximum inspiratory pressure (MIP%pred) and maximum expiratory pressure
(MEP%pred) were obtained before and after the 10-week intervention. Backward
multivariable regression analyses for the primary outcome (MIP%pred) were
conducted. Results After controlling for the initial MIP%pred, perceived fatigue at the baseline
and Trial% were significant and independent predictors of MIP%pred after
IMT. Conclusion Less fatigue at the baseline and higher adherence to the prescribed exercise
repetitions were positive predictors of the positive outcome following IMT
in PwAMS.
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Affiliation(s)
- Min Hui Huang
- Physical Therapy Department, College of Health Sciences, University of Michigan-Flint, Flint, MI, USA
| | - Lisa Doyle
- Doctor of Physical Therapy Program, Franklin Pierce University, Manchester, NH, USA
| | | | - Donna K. Fry
- College of Health Sciences, University of Michigan-Flint, Flint, MI, USA
| | - Keelin Shea
- Doctor of Physical Therapy Program, Franklin Pierce University, Manchester, NH, USA
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Strober LB, Bruce JM, Arnett PA, Alschuler KN, DeLuca J, Chiaravalloti N, Lebkuecher A, Di Benedetto M, Cozart J, Thelen J, Cadden M, Guty E, Román CAF. A much needed metric: Defining reliable and statistically meaningful change of the oral version Symbol Digit Modalities Test (SDMT). Mult Scler Relat Disord 2021; 57:103405. [PMID: 34923428 DOI: 10.1016/j.msard.2021.103405] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 10/31/2021] [Accepted: 11/13/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND The Symbol Digit Modalities Test (SDMT) has been recommended for use in clinical trials and outcome studies to monitor cognitive change. However, defining what is a meaningful change has been elusive for several years. OBJECTIVE The present investigation aimed to develop methods for assessing individual-level statistically significant change on the SDMT - reliable change indices (RCIs) and standardized regression-based (SRB) equations. METHODS A total of 219 healthy individuals completed the oral version SDMT at baseline, 6-month and 1-year follow-up. RESULTS The SDMT demonstrated high reliability across all time points (r's = 0.83 to 0.86). Reliable change scores of 7, 8, and 10 points for the 6-month intervals represented statistically meaningful change at the 0.70, 0.80, and 0.90 confidence intervals, respectively. Over 1-year, a difference of 8, 10, and 12 was statistically meaningful at the 0.70, 0.80, and 0.90 confidence intervals, respectively. SRB equations are also provided taking into account additional factors found to be predictive of SDMT scores over time. CONCLUSION Clinicians frequently denote a decline of 4 points on the SDMT as meaningful. Results in this large normative sample show that higher cut-points are needed to demonstrate statistically significant decline at the individual level. RCIs are provided for 6 month and one year assessment, which is typical in clinical practice and trials. SRB equations are also provided for use when applicable and may provide a more precise assessment of meaningful change.
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Affiliation(s)
- L B Strober
- Kessler Foundation, West Orange, NJ, USA; Rutgers, the State University of New Jersey, New Jersey Medical School, Department of Physical Medicine and Rehabilitation.
| | - J M Bruce
- University of Missouri-Kansas City School of Medicine, Department of Biomedical and Health Informatics
| | - P A Arnett
- The Pennsylvania State University, Department of Psychology
| | - K N Alschuler
- University of Washington, School of Medicine, Department of Rehabilitation Medicine; University of Washington, School of Medicine, Department of Neurology, UW Multiple Sclerosis Center
| | - J DeLuca
- Kessler Foundation, West Orange, NJ, USA; Rutgers, the State University of New Jersey, New Jersey Medical School, Department of Physical Medicine and Rehabilitation
| | - N Chiaravalloti
- Kessler Foundation, West Orange, NJ, USA; Rutgers, the State University of New Jersey, New Jersey Medical School, Department of Physical Medicine and Rehabilitation
| | | | | | - J Cozart
- University of Missouri-Kansas City School of Medicine, Department of Biomedical and Health Informatics
| | - J Thelen
- University of Missouri-Kansas City School of Medicine, Department of Biomedical and Health Informatics
| | - M Cadden
- The Pennsylvania State University, Department of Psychology; Harvard Medical School, Massachusetts General Hospital/Brigham and Women's Hospital
| | - E Guty
- The Pennsylvania State University, Department of Psychology
| | - C A F Román
- Kessler Foundation, West Orange, NJ, USA; The Pennsylvania State University, Department of Psychology
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Characterizing gaze and postural stability deficits in people with multiple sclerosis. Mult Scler Relat Disord 2021; 55:103205. [PMID: 34438218 DOI: 10.1016/j.msard.2021.103205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 07/28/2021] [Accepted: 08/06/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND People with Multiple Sclerosis (PwMS) experience a wide range of symptoms that can alter function and limit activity and community participation. Symptoms including sensory changes, weakness, fatigue and others have been well documented. However, symptoms related to changes in vestibular related function, including gaze and postural stability have not been fully explored. While some recent studies have begun to provide insight into these deficits in PwMS and have explored the use of rehabilitation paradigms for their management, much remains unknown about the full extent of these deficits. Therefore, this study aimed to characterize the presence of gaze and postural stability deficits in measures across the World Health Organization International Classification of Functioning, Disability, and Health (WHO ICF) and to examine how deficits in domains of body structure and function and activity contribute to participation level limitations. METHODS Baseline data from 41 PwMS (mean(SD) age = 53.9(11.2), 78% female) enrolled as part of a randomized clinical trial were used in this analysis. Measures of gaze and postural stability from the ICF domains of body structure and function (Vestibular ocular reflex [VOR] gain and postural sway area), activity (computerized dynamic visual acuity [cDVA] and MiniBEST test), and participation (Dizziness handicap inventory [DHI] and Activities Balance Confidence [ABC] scale) along with demographic data were used to characterize the sample. To explore relationships between ICF domains for gaze and postural stability, univariate correlations were performed between measures from each domain using Pearson's correlations. Separate multivariate regression models examined how measures from the body structure and function and activity domains contributed to the variance in the participation level outcomes. Variance explained by the models was quantified using R-squared statistic and contribution of the independent variables were quantified using the beta coefficient (p < 0.05). RESULTS Correlation analysis demonstrated significant relationships in the postural stability measures across domains. Specifically, between postural sway area on a firm surface and MiniBEST test score (r = -.48;p < 0.01) and MiniBEST test score and ABC score (r = 0.5;p < 0.01). Significant correlations were also found between the gaze stability measures of horizontal and vertical VOR gain (r = .68;p < 0.001), horizontal VOR gain and dynamic visual acuity (r = .38;p = 0.02), and vertical VOR gain and dynamic visual acuity (r = .54;p < 0.001). Regression models assessing postural stability, found that only the MiniBEST score significantly contributed to the variance in ABC score (p = 0.01) and the full model explained 34% of the variance in ABC score. Regression modeling of gaze stability outcomes did not produce any variable that significantly contributed to the variance in DHI score and the full model explained 18% of the variance in DHI score. CONCLUSIONS PwMS in this sample demonstrated deficits in gaze and postural stability across the domains of the WHO ICF compared to past samples of PwMS and healthy cohorts. Correlation between measures in the different domains were present, but no strong relationship between measures of body structure and function, activity and participation level outcomes were observed. This lack of relationship across the domains is likely contributed to the relatively small sample size, the high level of variability observed in the outcomes, and the diverse presentation often seen in PwMS.
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Postural stability is a valid and meaningful disability metric in progressive MS with potential for use in neuroprotective therapy trials. Mult Scler Relat Disord 2021; 52:102946. [PMID: 33901968 DOI: 10.1016/j.msard.2021.102946] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/24/2021] [Accepted: 04/07/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Balance impairment is observed in up to 70% of people with MS (pwMS) and worsens with disease progression. Posturography using a force platform is the current gold standard in the measurement of balance. However, posturography has not been adequately studied or widely accepted for use as a disability outcome measure for pwMS. Importantly, the recent emergence of both successful and failed neuroprotective therapy trials in progressive MS has emphasised the need for new disability outcome measures for people with progressive MS. The main objectives of this study were to evaluate the clinical validity, reliability and feasibility of posturography as a disability metric in progressive MS. METHODS This was a prospective cross-sectional study. We recruited 73 people with progressive MS (age 18-65 years, EDSS 3.5-6.0). Participants stood in the centre of a force platform, feet comfortably apart, under various conditions: (i) eyes open (EO), (ii) eyes closed (EC) - a single task, each lasting ninety seconds; and simultaneous EO with a cognitive test: (iii) N-Back, a three-minute test whereby participants were instructed to click the mouse when two identical letters were displayed consecutively on a screen, (iv) Sustained Attention Response Task, a five-minute test whereby participants were instructed to click the mouse for every number "1″ to "9″ except "3″ - i.e., dual-tasks. Additionally, we performed a battery of validated physical and cognitive outcome measures. Posturographic data was processed using Matlab. Statistical analysis was performed using SPSS version 26. We used multiple linear regression modelling to determine whether significant univariate correlations between posturography and clinical metrics were independent of covariates that may influence the associations seen. A two-tailed significance level of 0.05 was used. RESULTS Of 73 participants, mean age 52.4 (8.5) years, mean MS disease duration 13.8 (10.3) years, median EDSS 5.0 (IQR 4.0-6.0), 44 (60.4%) were female. EO-Path-Length independently predicted upper extremity function (9-Hole-Peg-Test) with a larger effect size (adjusted R2=20.0%, p = 0.001) than that for walking measures (Timed 25-Foot Walk, adjusted R2=1.6%, p = 0.01; Two-Minute Walk Test, adjusted R2=7.2%, p = 0.002), while controlling for age, disease duration, height, weight, and sex. The addition of EO-Mediolateral-Displacement to the MS Functional Composite (MSFC) created a four-component z-score that increased the variance explained for quality of life (QOL) by 62.1%. Postural stability was significantly lower with mediolateral vs anteroposterior direction of sway, removal of vision, increased body weight, male sex, and fampridine use. Postural stability improved during dual-tasks compared to EO single task. Posturography detected significant worsening of balance over a single prolonged stance. CONCLUSION Postural stability independently predicted a wide range of clinical metrics including upper extremity function, walking ability, cognition and QOL, therefore establishing construct and concurrent validity as a disability outcome measure for people with progressive MS. Additionally, posturography is a quantitative, non-invasive, quick-and-easy-to-administer, and highly sensitive device, demonstrating its high feasibility for use as a time- and resource-efficient disability metric in neuroprotective therapy trials for progressive MS.
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Cozart JS, Strober L, Ruppen S, Bradish T, Belcher C, Louthan T, Lam S, Thelen J, Bruce JM. A quick assessment of reliable change in fatigue: Reliable change indices of the modified fatigue impact scale - 5 item (MFIS-5). Mult Scler Relat Disord 2021; 49:102743. [PMID: 33486399 DOI: 10.1016/j.msard.2021.102743] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 12/11/2020] [Accepted: 01/05/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Reliably monitoring changes in fatigue is an ongoing concern. OBJECTIVE Evaluate reliable change using the Modified Fatigue Impact Scale 5-item version (MFIS-5) in people with MS (PwMS). METHODS The MFIS-5 was administered at three time points in 157 PwMS. Test-retest reliability and reliable change scores were calculated at the 0.70, 0.80, 0.90, and 0.95 confidence intervals. RESULTS Difference scores of 3, 4, 5, and 6 represent statistically meaningful change at the 0.70, 0.80, 0.90, and 0.95 confidence intervals, respectively. CONCLUSION Cut points derived from this study and prior work can help reliably assess changes in fatigue over time.
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Affiliation(s)
- J S Cozart
- University of Missouri-Kansas City, Department of Psychology, Kansas City, MO, USA; University of Missouri-Kansas City, School of Medicine, Department of Biomedical and Health Informatics, Kansas City, MO, USA
| | - L Strober
- Kessler Foundation, West Orange, NJ, USA; Rutgers, the State University of New Jersey, New Jersey Medical School, Department of Physical Medicine and Rehabilitation, Newark, NJ, USA
| | - S Ruppen
- University of Missouri-Kansas City, Department of Psychology, Kansas City, MO, USA; University of Missouri-Kansas City, School of Medicine, Department of Biomedical and Health Informatics, Kansas City, MO, USA
| | - T Bradish
- University of Missouri-Kansas City, School of Medicine, Department of Biomedical and Health Informatics, Kansas City, MO, USA
| | - C Belcher
- University of Missouri-Kansas City, Department of Psychology, Kansas City, MO, USA
| | - T Louthan
- University of Missouri-Kansas City, Department of Psychology, Kansas City, MO, USA
| | - S Lam
- University of Missouri-Kansas City, School of Medicine, Department of Biomedical and Health Informatics, Kansas City, MO, USA
| | - J Thelen
- University of Missouri-Kansas City, Department of Psychology, Kansas City, MO, USA; University of Missouri-Kansas City, School of Medicine, Department of Biomedical and Health Informatics, Kansas City, MO, USA
| | - J M Bruce
- University of Missouri-Kansas City, School of Medicine, Department of Biomedical and Health Informatics, Kansas City, MO, USA.
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Meca-Lallana V, Brañas-Pampillón M, Higueras Y, Candeliere-Merlicco A, Aladro-Benito Y, Rodríguez-De la Fuente O, Salas-Alonso E, Maurino J, Ballesteros J. Assessing fatigue in multiple sclerosis: Psychometric properties of the five-item Modified Fatigue Impact Scale (MFIS-5). Mult Scler J Exp Transl Clin 2019; 5:2055217319887987. [PMID: 31741743 PMCID: PMC6843745 DOI: 10.1177/2055217319887987] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 10/12/2019] [Indexed: 11/17/2022] Open
Abstract
Fatigue in multiple sclerosis is a key symptom associated with work-related problems and poor quality of life outcomes. The five-item Modified Fatigue Impact Scale is a brief self-assessment tool for measuring the impact of fatigue on cognitive, physical and psychosocial function. A non-interventional, cross-sectional study was conducted to assess dimensionality and item characteristics of the five-item Modified Fatigue Impact Scale in multiple sclerosis. A total of 302 subjects were studied. Mokken analysis found the five-item Modified Fatigue Impact Scale is a strong one-dimensional scale (overall scalability index H = 0.67) with high reliability (Cronbach's alpha = 0.90). The confirmatory factor analysis model confirmed the one-dimensional structure (comparative fit index = 1.0, root-mean-square error of approximation = 0.035). Samejima's model fitted well as an unconstrained model with different item difficulties. The five-item Modified Fatigue Impact Scale shows appropriate psychometric characteristics and may constitute a valuable and easy-to-implement addition to measure the impact of fatigue in clinical practice.
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Affiliation(s)
| | | | - Yolanda Higueras
- Department of Neurology, Instituto de Investigación Sanitaria Hospital Universitario Gregorio Marañón, Madrid, Spain
| | | | | | | | | | | | - Javier Ballesteros
- Department of Neurosciences, University of the Basque Country (UPV/EHU), Spain
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