The Fatigue Severity Scale

Krupp, Lauren; LaRocca, Nicholas G.; Muir-Nash, Joanne; Steinberg, Alfred D.

doi:10.1001/archneur.1989.00520460115022

Cited by 4,900 publications

(1,517 citation statements)

References 8 publications

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“…The physical subscales of the NFI-MS/BR, MFIS and FSS demonstrated the highest values. This finding is supported by evidence that relates fatigue as a primarily physical symptom 2,12 . The physical component of fatigue has been shown in many studies as a factor that interferes with activities of daily living and has an impact on quality of life 5,11 .…”

Section: Discussionmentioning

confidence: 52%

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Validation of the Brazilian version of the neurological fatigue index for multiple sclerosis

Lopes

Lavado

Kaimen-Maciel

2016

Arq. Neuro-Psiquiatr.

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Fatigue is the most frequent and severe of symptoms causing morbidity and disability in multiple sclerosis (MS) patients. However, measuring fatigue is a difficult task. There is no clear definition; it is complex and multidimensional, and is a highly subjective symptom with many uncertainties regarding its pathophysiology. No biological or neuroimaging markers for fatigue are currently known 1 . The lack of standardization for fatigue measurement has resulted in development of several assessment instruments, but none of them is universally accepted. The Fatigue Severity Scale (FSS) 2 and Modified Fatigue Impact Scale (MFIS) 3 are the most widely used instruments for measuring MS fatigue, although limitations regarding their development and measurement properties have been reported. Moreover, they were not specifically developed for MS patients 4,5,6 . Studies using the Rasch measurement model have identified a need for certain items to be removed from the FSS [4] and MFIS [6] so that their measurements can be considered valid and reliable.In Brazil, FSS 7 and MFIS 8 have been widely used, despite the failings of their design and psychometric properties in Brazilian cross-cultural adaptation studies. These Brazilian versions did not fulfill the criteria for adequate sample size and design. Moreover, the psychometric properties of the Brazilian FSS adaptation were not assessed. Therefore, there are no Brazilian MS-specific instrument for assessing fatigue with reported methodological and psychometric properties ABstrACtThe Neurological Fatigue Index for Multiple Sclerosis (NFI-MS) is a new fatigue assessment instrument. The aim of this study was to cross-culturally adapt and assess the psychometric properties of the Brazilian version of the NFI-MS (NFI-MS/BR). Method: Two hundred and forty subjects with MS were recruited for this study. The adaptation of the NFI-MS was performed by translation and back translation methodology. In psychometric analysis was performed the administration of the questionnaires Epworth Sleep Scale, Fatigue Severity Scale, Modified Fatigue Impact Scale, Multiple Sclerosis Impact Scale-29, NFI-MS/BR and Pittsburgh Sleep Quality Index with retest of the NFI-MS/BR after 7 days. Results: Reliability was assessed (intraclass correlation coefficients between 0.77 and 0.86), and validity by testing 41 hypotheses about expected correlations between subscales and confirmed 36. The majority of correlations were demonstrated. Conclusion: The NFI-MS/BR is a cross-culturally adapted, valid, and reliable instrument for assessing MS fatigue among Brazilian subjects.Keywords: multiple sclerosis; fatigue; assessment; validation studies; psychometrics. resumo O índice neurológico de fadiga na esclerose múltipla (EM) (NFI-MS) é um novo instrumento de avaliação da fadiga. O objetivo deste estudo foi adaptar transculturalmente e avaliar as propriedades psicométricas da versão Brasileira do NFI-MS (NFI-MS/BR).Método: Duzentos e quarenta indivíduos com EM participaram deste estudo. A adaptação do NFI-MS/BR f...

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Section: Discussionmentioning

confidence: 52%

“…The Fatigue Severity Scale (FSS) 2 and Modified Fatigue Impact Scale (MFIS) 3 are the most widely used instruments for measuring MS fatigue, although limitations regarding their development and measurement properties have been reported. Moreover, they were not specifically developed for MS patients 4,5,6 .…”

mentioning

confidence: 99%

Validation of the Brazilian version of the neurological fatigue index for multiple sclerosis

Lopes

Lavado

Kaimen-Maciel

2016

Arq. Neuro-Psiquiatr.

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“…The Hamilton Rating Scale for Depression ( Ham‐D ) (Hamilton, 1960) was administered by a specialist for psychiatry to evaluate comorbid depressive symptoms (score from 0 to 50 points, 8–13 = mild depression; 14–18 = moderate depression; 19–22 = severe depression; ≥23 = very severe depression, duration about 15 min) and the Parkinson neuropsychometric dementia assessment ( PANDA ) (Kalbe et al., 2008) to assess PD‐related cognitive deficits (score from 0 to 30 points, duration about 15 min). Additionally, patients assessed themselves based on the (i) Parkinson's Disease Questionnaire ( PDQ‐39 ) (Peto, Jenkinson, Fitzpatrick, & Greenhall, 1995) to evaluate disease‐specific functioning and quality of life (score from 0 to 100%, duration about 15 min), the (ii) Fatigue Severity Scale ( FSS ) (Krupp, LaRocca, Muir‐Nash, & Steinberg, 1989) to assess severity of disease‐related fatigue (score from 9 to 63 points, duration about 5 min), (iii) the self‐assessment part of the MDS‐UPDRS to quantify the subjective presence of motor and nonmotor symptoms (score from 0 to 80 points, duration about 10 min), (iv) the brief‐COPE (Knoll, Rieckmann, & Schwarzer, 2005) to assess the individual use of different coping strategies (0 to 8 points per dimension, duration about 10 min), and (v) the NEO Five‐Factor Inventory ( NEO‐FFI ) (Borkenau & Ostendorf, 2008) to evaluate the five personality factors neuroticism, extroversion, agreeableness, openness to experience, and conscientiousness (0 to 4 points per dimension, duration about 15 min). Moreover, caregivers evaluated impairments in goal‐directed behavior in four domains by the apathy evaluation score ( AES ) (Marin, 1991) (here expressed as ratio of each maximum subscore, duration about 5 min).…”

Section: Methodsmentioning

confidence: 99%

Relationships between activity and well‐being in people with parkinson's disease

et al. 2018

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ObjectivesThe complex symptomatology of Parkinson’ disease (PD) usually goes along with reduced physical activity. Previous studies have indicated positive effects of activating therapies on patients’ well‐being. This study, therefore, examined how activity in daily life is related to patients’ subjective condition.Materials and MethodsTwenty‐one PD patients rated their condition every two hours during two routine days and documented the duration and type of their activities (based on the PRISCUS‐Physical Activity Questionnaire) during the respective time intervals. They were furthermore assessed regarding motor and nonmotor symptoms, personality factors, and coping strategies.ResultsPatients spent on average 8.59 ± 2.93 hr per day at physical rest and 5.47 ± 2.93 hr physically active. We found highly significant associations between positive condition ratings (such as happiness, motivation, and concentration) and the duration of subsequent physical activities (adj.r 2 = .689) as well as between the duration of these activities and a subsequent improvement in the subjective condition (adj.r 2 = .545). This was strongest in patients using active coping strategies and showing agreeable and conscientious personality traits (adj.r 2 = .380). Nonmotor symptom severity was weakly inversely related to the daily amount of activities (adj.r 2 = .273), whereas no significant association with motor symptom severity was found.ConclusionsThe results suggest a feedback process between a positive subjective condition and physical activities in PD patients. This appears to depend on the use of active coping strategies and nonmotor symptoms rather than on motor symptom severity. The results should encourage physicians to address the importance of everyday physical activities and to provide patients with behavioral advice.

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“…1). Fatigue, depression, and quality of life were assessed using the fatigue severity scale (FSS), the Beck Depression Inventory (BDI), the EuroQol five dimensional questionnaire (EQ‐5D), and the quality of life visual analogue scale (QolVas) as self‐assessment scales (Krupp, LaRocca, Muir‐Nash, & Steinberg, 1989; Moran & Mohr, 2005; Rabin & de Charro, 2001). …”

Section: Methodsmentioning

confidence: 99%

Dalfampridine effects on cognition, fatigue, and dexterity

et al. 2016

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ObjectivesDalfampridine exerts beneficial effects on walking ability in a subgroup of patients with multiple sclerosis (MS). These patients are termed “responders”. Here, we investigated whether the responder status with respect to mobility measures would determine whether dalfampridine treatment exerts a beneficial effect on other MS symptoms. We therefore assessed walking ability, upper limb function, cognition, fatigue, visual evoked potentials (VEPs), depression, and quality of life in patients before and after dalfampridine treatment.MethodsPatients with MS and impaired mobility were recruited. Maximal walking distance, timed 25 Foot Walk, nine hole peg test, paced auditory serial addition test (PASAT), fatigue severity scale (FSS), VEPs, Beck Depression Inventory (BDI), EuroQol five dimensional questionnaire, and quality of life visual analogue scale were determined before and after 12–14 days of dalfampridine treatment. Repeated measures analysis of variance was applied to determine the effect of dalfampridine treatment.ResultsOf the 34 patients who completed the study, 22 patients were responders and 12 patients nonresponders, according to their performance in mobility measures. Treatment effects for the entire patient cohort were observed for PASAT (p = .029) and BDI (p = .032). Belonging to the responder cohort did not predict the response to treatment in these tests. For the FSS, response to dalfampridine treatment was dependent on the responder status (p = .001) while no effects in the total patient cohort were observed (p = .680). Other neurological functions remained unaltered. For VEP latencies, no significant improvements were detected.ConclusionIn this study, we observed beneficial effects of dalfampridine on cognition, depression, and fatigue. These effects were not limited to patients who responded to dalfampridine with improved mobility measures. These findings underscore the need to assess the beneficial effects of dalfampridine on neurological deficits in MS patients in additional randomized clinical trials.

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The Fatigue Severity Scale

Cited by 4,900 publications

References 8 publications

Validation of the Brazilian version of the neurological fatigue index for multiple sclerosis

Validation of the Brazilian version of the neurological fatigue index for multiple sclerosis

Relationships between activity and well‐being in people with parkinson's disease

Dalfampridine effects on cognition, fatigue, and dexterity

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