Correlation of fatigue with disability and accelerometer-measured daily physical activity in patients with relapsing-remitting MS 2023 Luostarin et al

Highlights

• A significant correlation was found to exist between fatigue and disability.
• Total daily activity correlated with fatigue.
• A lower disability rate, better physical condition, and higher daily-living activity were found to predict lower fatigue levels.

Abstract

Background
Fatigue is one of the most common symptoms in patients with multiple sclerosis (MS). Furthermore, measuring its effects on patients in daily life is challenging. This study aimed to discover the association between relapsing-remitting MS (RRMS) patients’ disability, fatigue, and accelerometer-measured physical activity.

Methods
A total of 41 patients with RRMS with an Expanded Disability Status Scale (EDSS) level of 0–5.5 and 20 healthy controls completed the Modified Fatigue Impact Scale (MFIS) and the Fatigue Severity Scale (FSS) questionnaires. The EDSS was evaluated for all patients with RRMS, and all participants performed the MS Functional Composite (MSFC) test and six-min walk test and wore an accelerometer for seven days.

Results
Patients with an EDSS level of 0–2.5 were found to have higher fatigue levels (p < 0.001) than healthy controls but lower levels than patients with an EDSS level of 3–5.5 (p < 0.001). A significant correlation was found to exist between fatigue and disability level measured by the EDSS (EDSS/FSS, r=0.750/p=0.001; EDSS/MFIS, r=0.661/p=0.001) and with the MSFC test in the patient group (MSFC/FSS, r = −0.350 p=0.025; MSFC/MFIS, r = −0.423/p=0.007). Total daily activity correlated with fatigue as measured by the FSS (MVPS/FSS r = −0.357/p=0.028, step count/FSS r = −0.463/p=0.003), but no correlation was found between the EDSS or the MSFC.

Conclusion
A lower disability rate, better physical condition, and higher daily-living activity were found to predict lower fatigue levels.

Open access, https://www.msard-journal.com/article/S2211-0348(23)00409-1/fulltext

 

Or vice-versa.

 

Wow, deep, eh?!

 

I don't know how much push there is to get MS patients to "exercise, and you will recover".

For some, the buck always stops at the patient's door. The belief that " if you want to recover, and work at it, you will succeed."

 

Don't tell Hans Knoop and Chantal Rovers!

 

From the conclusion of the paper:

"Fatigue plays a significant role in MS and has a strong effect on disability and, for example, the retirement of patients with MS. This study clearly demonstrated a link between fatigue and functional capacity. Disability and fatigue were also clearly associated with patients’ endurance capacity. The amount of daily physical activity by patients was related to their level of fatigue. A lower disability rate, better physical condition, and higher daily activity predicted lower fatigue levels. Thus, a suitable form of exercise should be found for MS patients, considering their functional capacity, to maintain their ability to function as well as possibly reduce their incidence of fatigue. This research is unique because it was extensive and used modern methods. Furthermore, more specific research is required into patients’ disability and actual physical activity levels, taking the existing levels of patients’ disability into account."

 

From an institute of sports medicine.
So now MS is a sporting injury?

 

The lead author and several others are from the Institute of Biomedicine, Sports and Exercise Medicine, University of Eastern Finland, Kuopio, Finland, who state on their website, "We conduct research ranging from population-based studies to molecular medicine to uncover basic mechanisms behind chronic diseases such as Alzheimer’s disease, cancer, type 2 diabetes and cardiovascular diseases.", so I would say no, they don't view MS as a sporting injury.

 

Ah, sports medicine.... rather akin to BPS methods. Or maybe very much in tune with GET/CBT, as presented by the BPS group.

 

Well they clearly see it as fair game for a bit of exercise therapy.
Sometimes what it says on the tin isn't the whole story!
Nobody with any humility would claim to be uncovering basic mechanisms in that lot.

 

Illness, so complicated.

Well, for some adults, I guess. Children understand this easily.

 

Although we were assured by very serious experts in the field that there is no relation at all between fatigue and functioning. Oddly enough.

Again, something that children can easily see through. How weird.

 

This is simply asinine. It's like having as the universal answer to poverty that poor people should just buy some money. With their lack of money.

Yet again, something that children can easily understand. There's some kind of very weird pattern happening here, where people just straight up refuse to reason over easy stuff.

 

Sports medicine is scientific. BPS just appear to have hijacked terminologies e.g graded exercise without the scientific biology underpinnings of the treatments/rehab because their version is for mental illnesses.

 

I've had a couple unfortunate experiences with sports medicine practitioners. Both involved unwarranted criticism, and one of these instances included ridicule in front of others re ME. So although this field is science based, some of the professionals in this discipline leave much to be desired. Just as in other areas.