Fatigability Assessment Using the Fatigue Index Kliniken Schmieder (FKS) Is Not Compromised by Depression

Abstract

Background: Attractor-based kinematic gait analysis using the Fatigue Index Kliniken Schmieder (FKS), have been suggested as a sensitive tool to determine motor fatigability in persons with Multiple Sclerosis (pwMS). Hypothesis: Depression does not affect the FKS to a similar degree as in pwMS. Methods: We recruited 32 patients with major depression. Data were collected with two accelerometers attached to both ankles. Data were recorded for one minute at the beginning and at the end of the treadmill test. Attractor attributes were used to analyze the data. Results: The mean Fatigue Index Kliniken Schmieder (FKS) was 2.1. The change of the attractor (δM) was 3.7 and the change of variability (δD) was 0.6. Mean values were clearly below values of pwMS with fatigability from a previous publication. However, the individual level values from six individuals-five of them showed pain related comorbidity besides depression-fell within the lower pathological range. There was no correlation between Hamilton depression scale and the attractor attributes (δM and δD). Discussion: Depression does not affect gait as motor fatigability does in pwMS.Results from subjects with pain during the treadmill test show a moderately increased variability and moderately altered attractors.

Prominent Fatigue but No Motor Fatigability in Non-Hospitalized Patients With Post-COVID-Syndrome

“…In all, except for two, initially non-hospitalized patients with post-COVID-syndrome complaining of serious motor fatigue [FSMC Motor averaged 37.1 ± 7.8 (= severe Fatigue)], we found no gait abnormalities during walking till exhaustion; suggesting no organic lesion in the central motor system comparable to those found in patients with MS. The latter had also been reported in a previous study for patients with depression (17). Thus, this marks a striking difference from the common finding of motor fatigability in patients with MS (14,39).…”

“…The FKS is a sensitive measure to capture motor performance fatigability (17,39). From all participating patients, attractors of their gait tests were calculated and the respective FKS was determined according to the attractor method algorithm (Figure 3).…”

“…More sophisticated are measurements using motion-sensitive (IMU) sensors fixed to the ankle in combination with an attractor-based evaluation (14)(15)(16). This change in gait performance is not found in, e.g., depressive disorders (17) and is interpreted as a demonstration of an organic lesion of the central nervous system, possibly comparable to a use-or activity-dependent conduction block (18). The correct discrimination between organic and psychological causes of fatigue and fatigability is helpful to define the best therapy in individual cases of MS.…”

Fatigue und Fatigability bei Multipler Sklerose – Leistungsbeurteilung

“…Wenn MS-Patienten gehen, bis sie erschöpft sind, kommt es häufig zu gut sichtbaren Gangbildveränderungen wie einer Zunahme des Fall-Fußes, einem Durchschlagen des Knies, einem Schleifen der Zehenspitze oder einem Stolpern oder auch einer Zunahme der Gangataxie. Diese Gangbildveränderungen sind organisch bedingt durch ein Nachlassen der Leitfähigkeit und können nicht durch Depression verursacht sein [17]. Sie lassen sich vom geübten Krankengymnasten erkennen, beschreiben und im Rahmen des Assessments bei Aufnahme und Entlassung dokumentieren [18,19].…”