Fatigue is a common symptom in ms, even early in the. The fatigue severity scale fss was developed by lauren krupp, md, a neurologist who specializes in ms, to address this. Sustainedreleased fampridine in multiple sclerosis. Essentially, the fss consists of answering a short questionaire that requires the subject to rate his or her own level of fatigue. We prospectively assessed the presence of severe fatigue, as defined by a score of. Both of these other instruments also demonstrate a single factor that can be thought of as assessing severity of fatigue. Modified fatigue impact scale mfis fatigue is a feeling of physical tiredness and lack of energy that many people experience from time to time. Fatigue severity scale an overview sciencedirect topics. The results further showed that fatigue was largely independent of selfreported depressive symptoms and that several characteristicscould differentiate fatigue that accompanies multiple sclerosis from fatigue that accompanies systemic lupus erythematosus. Jul 03, 2019 to evaluate the psychometric properties of an item fatigue severity measure, the chalder fatigue questionnaire cfq in ms including validity of the factor structure, internal reliability, discriminant validity fatiggue sensitivity to change. The original version, the fatigue impact scale, was sensitive in discriminating the effects of fatigue among ms from those of patients with chronic fatigue syndrome and essential hypertension. Fatigue affects people in different ways that can change day to day. Population for testing the scale was initially validated in a population of patients with multiple sclerosis and systemic lupus erythematosus.
Fatigue rating scales critique and recommendations by the task. The fatigue severity scale fss is designed to differentiate fatigue from clinical depression, since both share some of the same symptoms. Disease steps ds this is a simple way to measure ms disability, mainly based on your ability to walk. Administration of the fatigue severity scale to 25 patients with multiple sclerosis, 29 patients with systemic lupus erythematosus, and 20 healthy adults revealed that. The authors found that autonomic responses correlated with fatigue resembling a hypoadrenergic orthostatic response, possibly due to a sympathetic vasomotor lesion. The global msss can be used as a reference table for future disability comparisons.
Fatigue severity scale fss perelman school of medicine. Sep 23, 2003 the authors studied standard autonomic function tests and measures of heart rate variability in 60 patients with multiple sclerosis ms and correlated results with the fatigue severity scale and the modified fatigue impact scale. The items are scored on a 7 point scale with 1 strongly disagree and 7 strongly agree. The majority of approaches for managing ms fatigue typically require participation in a structured, timelimited program with a fixed sequence of topics and activities. Fatigue is a problem experienced by many patients suffering from chronic diseases, including sarcoidosis patients. The fulllength version of the mfis has a cronbachs alpha of. We aimed to study the relationship between fatigue in ms and the presence of focal dysfunction in the basal ganglia and frontal white matter. The fatigue severity scale fss is a method of evaluating fatigue in multiple sclerosis and other conditions including chronic fatigue immune dysfunction syndrome cfids and systemic lupus erythmatosis sle the fatigue severity scale fss is designed to differentiate fatigue from clinical depression, since both share some of the same symptoms.
However, little is known about the treatments effect on temporospatial gait parameters, walking endurance, general fatigue, hand function and quality of life qol. A visual analogue scale is also included with the scale. Novel method for measurement of fatigue in multiple sclerosis. And, the various ms types of disease progress in different ways, too. Ninetyseven patients 38% suffered from severe fatigue, whereof 69 underwent overnight respirography. Aug 17, 2006 fatigue is a common complaint in multiple sclerosis ms and often interferes with daily functioning. Jul 15, 2019 the fatigue severity scale fss is meant to evaluate the impact of fatigue on a persons life. The scale has been found to have good testretest reliability dittner et al. Fatigue severity scale geriatric assessment tool kit. A rapid screening tool for fatigue impact in multiple sclerosis. Aug 17, 2015 to develop and test the psychometric properties of an arabic version of fatigue severity scale fssar that can be used to measure fatigue in arabic patients with disorders where fatigue is a major symptom. Realtime assessment of fatigue in patients with multiple sclerosis. Introduction fatigue is a major cause of disability in individuals with multiple sclerosis ms and is associated with a reduced quality of life.
Fatigue is a feeling of physical tiredness and lack of energy that many people experience from time to time. If people sleep in the day because of fatigue, it doesnt affect their ability to sleep at night. Both clinicians and researchers may need to detect high levels of fatigue impact using a time and effort efficient tool. This refers to your usual way of life within the last week. Because the mfis assesses the impact of fatigue, it should converge with other subjective measures of fatigue. There is a very complex relationship between fatigue and sleep. Minimally important difference of the fatigue severity scale. The fatigue severity scale is a frequently used patientreported measure.
A multisite, randomized controlled trial of ms inform, a. Included in the study were 41 patients with relapsingremitting ms. To facilitate research in this area, we developed a fatigue severity scale, subjected it to tests of internal consistency and validity, and used it to compare fatigue in two chronic conditions. Fatigue is a common symptom experienced by people with ms. An interactive fatigue management resource is a selfdirected ms fatigue management resource incorporating. Jul 12, 2018 the modified fatigue impact scale is a list of 21 statements that helps doctors evaluate how fatigue impacts someones daily life.
Other clinicianinitiated intervention strategies include exercise, therapy, and medication. Studies assessing the severity of fatigue using the. Nov 20, 2000 the performance of the bfi in this study is virtually interchangeable with a. The mfis is a modified form of the fatigue impact scale fisk et al, 1994b based on items derived from interviews with ms patients concerning how fatigue impacts their lives. Ms fatigue ms fatigue can be one of the most disabling symptoms of ms.
A questionnaire including the fatigue severity scale fss was mailed to a community sample of 502 ms patients three times 1 year apart. Fatigue and ms national multiple sclerosis society. Originally developed for use among individuals with multiple sclerosis. According to some studies, over 90% of people with ms experience fatigue. The multiple sclerosis severity score msss is a powerful method for comparing disease progression using single assessment data. It doesnt really measure severity but it is quite useful. Both scales were administered prior to starting natalizumab and 3 and 6 months after therapy. A total score of 36 or more suggests that you may need further evaluation by a physician. Fatigue severity scale multiple sclerosis encyclopaedia. Please circle the number between 1 and 7 which you feel best fits the following statements.
People with ms describe it as an overwhelming sense of tiredness with no obvious cause. This instrument provides an assessment of the effects of fatigue in terms of physical, cognitive, and psychosocial functioning. We therefore sought to evaluate these parameters in a realworld setting. Originally, the cutoff for severe fatigue was set at an. Scans and other multiple sclerosis tests dont always tell the. Krupps and colleagues in the late 1980s as a tool to assess fatigue in patientswith multiple sclerosis and systemic lupus erythematosus. Fatigue severity scale fss spinal cord injury research. Validation of an arabic version of fatigue severity scale. Oct 23, 2007 the origin of fatigue in multiple sclerosis ms remains uncertain. This study evaluates the psychometric properties of a rapid screening instrument for fatigue impact in multiple sclerosis. Fatigue severity scale the fatigue severity scale fss is designed to differentiate fatigue from clinical depression, since both share some of the same symptoms. The fatigue severity scale the fatigue severity scale can be used to monitor change in fatigue over time or in response to therapeutic interventions. Psychometric properties of the fatigue severity scale. Fatigue is an invisible symptom of multiple sclerosis.
The modified fatigue impact scale is a list of 21 statements that helps doctors evaluate how fatigue impacts someones daily life. These and other measures, as well as the relationship to neuroimaging findings, are. Following is a list of statements that describe the effects of. The fatigue severity scale fss, another validated scale, contains nine statements concerning the severity, impact, and frequency of fatigue on daily living, with a scale of 17.
Application to patients with multiple sclerosis and systemic lupus erythematosus article pdf available in jama neurology 4610. However, the use of nonconventional magnetic resonance techniques has increased our understanding of this problem. This is particularly useful for people with msrelated fatigue. Selecting a fatigue rating scale by fred friedberg, phd and. Administration of the fatigue severity scale to 25 patients. Doctors use it as a way to know when to begin therapy and to tell. Outcome measure fatigue severity scale fss sensitivity to change yes population adult domain tbirelated symptomsfatigue type of measure selfreport icfcodes b4 description the fss is a 9item scale that measures the severity of fatigue and how much it affects the persons activities and lifestyle in patients with a variety of disorders. While useful for comparing groups of patients, disease fluctuation precludes its use as a predictor. Fatigue is an extremely common symptom of multiple sclerosis ms and one of the most disabling complications of the disease. Multiple sclerosis progression varies from person to person. In order to categorize severity of fatigue in people with ms, researchers have used a variety of different criteria. The characteristics that distinguished fatigue in ms patients and controls are presented in table 2. The rapid assessment of fatigue severity in cancer patients. The fatigue severity scale fss was developed by lauren krupp, md, a neurologist who specializes in ms, to address this overwhelming ms symptom.
Introduction multiple sclerosis ms is a chronic illness that has some overlapping symptoms with myalgic encephalomyelitis me and chronic fatigue syndrome cfs. Due to the subjective nature of fatigue, patient reported outcome measures proms are commonly used to assess the severity and impact of fatigue, and two of the most frequently used in studies involving people with ms are the fatigue severity scale fss and the modified fatigue impact scale mfis blikman et al. Some studies indicate that fatigue affects approximately 85% of the ms population and nearly 66% of this population experiences it daily. Q why do my patients with multiple sclerosis experience so much fatigue, and what can i do to help them. We sought to identify clinical characteristics and socio. But people who have medical conditions like ms experience stronger feelings of fatigue more often and with greater impact than others.
The mfis does have moderate to strong correlations with the fatigue severity scale fss, a measure of fatigue in general use,11,12 which is not surprising given that the. Differentiating multiple sclerosis from myalgic encephalomyelitis and chronic fatigue syndrome. Jun 25, 2019 fatigue is one of the most common and debilitating symptoms of multiple sclerosis ms. About 50 percent of people with ms sleep during the day and most find this helps to reduce fatigue, even if it is just a short nap.
Captures the individuals experience of mental or psychological fatigue and how it interferes with performing certain activities exercise, work and family life. A prospective study of patterns of fatigue in multiple sclerosis. The fatigue severity scale fss is a method of evaluating fatigue in multiple sclerosis and other conditions including chronic fatigue immune dysfunction syndrome cfids and systemic lupus erythmatosis sle. Fatigue and sleepdisordered breathing in multiple sclerosis. Severity of sleepiness is an important confounder to take into account in the as sessment of fatigue. But people with fatigue related to ms, sle or cfids average about 6. Patients are asked to respond to each statement on a scale of 1 to 7, with 1 indicating strongly disagree and 7 indicating strongly agree. Using the fatigue severity scale to inform healthcare decision. Fatigue severity scale fss of sleep disorders healthywomen. Outcome measure fatigue severity scale fss moving ahead cre. Psychometric properties of the modified fatigue impact scale. Sustainedrelease fampridine fampridinesr improves gait velocity and selfperceived capacities in people with multiple sclerosis ms. Higher scores on the scale are indicative of more severe fatigue.