Effect of time of day on walking capacity and self-reported fatigue in persons with multiple sclerosis: a multi-center trial

Feys, Peter; Gijbels, Domien; Romberg, Anders; Santoyo, Carme; Gebara, Benoit; Noordhout, B. Maertens de; Knuts, Kathy; Béthoux, François; Groot, Vincent de; Vaney, Claude; Dalgas, Ulrik

doi:10.1177/1352458511419881

Cited by 55 publications

(53 citation statements)

References 31 publications

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“…The Multiple Sclerosis Council for Clinical Practice Guidelines defines fatigue as 'a subjective lack of physical and/or mental energy that is perceived by the individual or caregiver to interfere with usual or desired activity' [Paralyzed Veterans of America, 1998]. In contrast to excessive daytime sleepiness, if the patient feels most energized at the start of their day or at the beginning of a specific activity, but develops a sense of diminishing physical or mental energy over time or with prolonged activity [Claros-Salinas et al 2010;Feys et al 2012], fatigue is more likely to be a medically accurate characterization of the problem. Nonetheless, while such descriptions may be useful to distinguish symptoms of fatigue from sleepiness, few if any data exist that directly contrast phenotypic differences in fatigue that arises from MS versus fatigue secondary to an underlying sleep disorder in this population.…”

Section: Fatigue and Other Consequences Of Sleep Disorders In Msmentioning

confidence: 99%

A practical approach to the diagnosis and management of sleep disorders in patients with multiple sclerosis

Braley

Chervin

2015

Ther Adv Neurol Disord

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Abstract:Patients with multiple sclerosis (MS) are at increased risk for comorbid sleep disturbances, which can profoundly contribute to poor functional status and fatigue. Insomnia, sleep-disordered breathing, and restless legs syndrome are among the most common sleep disorders experienced by patients with MS. Despite their impact, these underlying sleep disorders may escape routine clinical evaluations in persons with MS, thereby leading to missed opportunities to optimize functional status and quality of life in patients with MS. A practical, systematic approach to the evaluation and treatment of sleep disorders in MS, in the context of MS-specific variables that may influence risk for these conditions or response to therapy, is recommended to facilitate early diagnosis and successful treatment. This review summarizes the most common sleep disorders experienced by persons with MS, and offers a practical approach to diagnosis and management of these conditions.

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Section: Fatigue and Other Consequences Of Sleep Disorders In Msmentioning

confidence: 99%

A practical approach to the diagnosis and management of sleep disorders in patients with multiple sclerosis

Braley

Chervin

2015

Ther Adv Neurol Disord

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“…Table 1 provides demographics and clinical characteristics of the remaining participants ( n = 42). Based on median EDSS scores, our sample of pwMS had mild clinical disability [26]. Of the participants, 12 (29%) reported using a straight cane for community ambulation.…”

Section: Resultsmentioning

confidence: 99%

Dynamometer-based measure of spasticity confirms limited association between plantarflexor spasticity and walking function in persons with multiple sclerosis

2014

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The literature shows inconsistent evidence regarding the association between clinically assessed plantarflexor (PF) spasticity and walking function in ambulatory persons with multiple sclerosis (pwMS). The use of a dynamometer-based spasticity measure (DSM) may help to clarify this association. Our cohort included 42 pwMS (27 female, 15 male; age: 42.9 +/− 10.2 yr) with mild clinical disability (Expanded Disability Status Scale score: 3.6 +/− 1.6). PF spasticity was assessed using a clinical measure, the modified Ashworth Scale (MAS), and an instrumented measure, the DSM. Walking function was assessed by the timed 25-foot walk test (T25FWT), the 6-minute walk test (6MWT), and the 12-item Multiple Sclerosis Walking Scale (MSWS-12). Spearman rho correlations were used to evaluate relationships between spasticity measures, measures of walking speed and endurance, and self-perceived limitations in walking. The correlation was small between PF spasticity and the T25FWT (PF maximum [Max] MAS rho = 0.27, PF Max DSM rho = 0.26), the 6MWT (PF Max MAS rho = −0.20, PF Max DSM rho = −0.21), and the MSWS-12 (PF Max MAS rho = 0.11, PF Max DSM rho = 0.26). Our results are similar to reports in other neurologic clinical populations, wherein spasticity has a limited association with walking dysfunction.

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“…The 6MTWT and 6MWT were standardized using a static start, and patients were asked to walk at a comfortable, usual speed [8, 20, 21] to ensure safety, as many tests were executed in the confined space of private practices. A 20% change was used as the threshold for change [21–24]. …”

Section: Methodsmentioning

confidence: 99%

Patient-reported questionnaires in MS rehabilitation: responsiveness and minimal important difference of the multiple sclerosis questionnaire for physiotherapists (MSQPT)

Maas¹

2017

BMC Neurol

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BackgroundThe Multiple Sclerosis Questionnaire for Physical Therapists (MSQPT) is a patient-rated outcome questionnaire for evaluating the rehabilitation of persons with multiple sclerosis (MS). Responsiveness was evaluated, and minimal important difference (MID) estimates were calculated to provide thresholds for clinical change for four items, three sections and the total score of the MSQPT.MethodsThis multicentre study used a combined distribution- and anchor-based approach with multiple anchors and multiple rating of change questions. Responsiveness was evaluated using effect size, standardized response mean (SRM), modified SRM and relative efficiency. For distribution-based MID estimates, 0.2 and 0.33 standard deviations (SD), standard error of measurement (SEM) and minimal detectable change were used. Triangulation of anchor- and distribution-based MID estimates provided a range of MID values for each of the four items, the three sections and the total score of the MSQPT. The MID values were tested for their sensitivity and specificity for amelioration and deterioration for each of the four items, the three sections and the total score of the MSQPT. The MID values of each item and section and of the total score with the best sensitivity and specificity were selected as thresholds for clinical change.The outcome measures were the MSQPT, Hamburg Quality of Life Questionnaire for Multiple Sclerosis (HAQUAMS), rating of change questionnaires, Expanded Disability Status Scale, 6-metre timed walking test, Berg Balance Scale and 6-minute walking test.ResultsThe effect size ranged from 0.46 to 1.49. The SRM data showed comparable results. The modified SRM ranged from 0.00 to 0.60. Anchor-based MID estimates were very low and were comparable with SD- and SEM-based estimates. The MSQPT was more responsive than the HAQUAMS in detecting improvement but less responsive in finding deterioration. The best MID estimates of the items, sections and total score, expressed in percentage of their maximum score, were between 5.4% (activity) and 22% (item 10) change for improvement and between 5.7% (total score) and 22% (item 10) change for deterioration.ConclusionsThe MSQPT is a responsive questionnaire with an adequate MID that may be used as threshold for change during rehabilitation of MS patients.Trial registrationThis trial was retrospectively (01/24/2015) registered in ClinicalTrials.gov as NCT02346279.Electronic supplementary materialThe online version of this article (doi:10.1186/s12883-017-0834-1) contains supplementary material, which is available to authorized users.

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Effect of time of day on walking capacity and self-reported fatigue in persons with multiple sclerosis: a multi-center trial

Abstract: Testing of walking capacity is unaffected by time of day, despite changes in subjective fatigue.

Cited by 55 publications

References 31 publications

A practical approach to the diagnosis and management of sleep disorders in patients with multiple sclerosis

A practical approach to the diagnosis and management of sleep disorders in patients with multiple sclerosis

Dynamometer-based measure of spasticity confirms limited association between plantarflexor spasticity and walking function in persons with multiple sclerosis

Patient-reported questionnaires in MS rehabilitation: responsiveness and minimal important difference of the multiple sclerosis questionnaire for physiotherapists (MSQPT)

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