Three Distinct Physical Behavior Types in Fatigued Patients with Multiple Sclerosis

Overview

Journal J Neuroeng Rehabil

Publisher Biomed Central

Specialties Biomedical Engineering
Neurology
Rehabilitation Medicine

Date 2019 Aug 25

PMID 31443714

Citations 6

Authors

H E M Braakhuis

M A M Berger

G A van der Stok

J van Meeteren

V de Groot

H Beckerman

J B J Bussmann

Affiliations

Soon will be listed here.

Abstract

Background: Multiple sclerosis often leads to fatigue and changes in physical behavior (PB). Changes in PB are often assumed as a consequence of fatigue, but effects of interventions that aim to reduce fatigue by improving PB are not sufficient. Since the heterogeneous nature of MS related symptoms, levels of PB of fatigued patients at the start of interventions might vary substantially. Better understanding of the variability by identification of PB subtypes in fatigued patients may help to develop more effective personalized rehabilitation programs in the future. This study aimed to identify PB subtypes in fatigued patients with multiple sclerosis based on multidimensional PB outcome measures.

Methods: Baseline accelerometer (Actigraph) data, demographics and clinical characteristics of the TREFAMS-ACE participants (n = 212) were used for secondary analysis. All patients were ambulatory and diagnosed with severe fatigue based on a score of ≥35 on the fatigue subscale of the Checklist Individual Strength (CIS20r). Fifteen PB measures were used derived from 7 day measurements with an accelerometer. Principal component analysis was performed to define key outcome measures for PB and two-step cluster analysis was used to identify PB types.

Results: Analysis revealed five key outcome measures: percentage sedentary behavior, total time in prolonged moderate-to-vigorous physical activity, number of sedentary bouts, and two types of change scores between day parts (morning, afternoon and evening). Based on these outcomes three valid PB clusters were derived.

Conclusions: Patients with severe MS-related fatigue show three distinct and homogeneous PB subtypes. These PB subtypes, based on a unique set of PB outcome measures, may offer an opportunity to design more individually-tailored interventions in rehabilitation.

Trial Registration: Clinical trial registration no ISRCTN 82353628 , ISRCTN 69520623 and ISRCTN 58583714 .

Citing Articles

Wearable Sensor Technologies to Assess Motor Functions in People With Multiple Sclerosis: Systematic Scoping Review and Perspective.

Woelfle T, Bourguignon L, Lorscheider J, Kappos L, Naegelin Y, Jutzeler C J Med Internet Res. 2023; 25:e44428.

PMID: 37498655 PMC: 10415952. DOI: 10.2196/44428.

Methodological heterogeneity biases physical activity metrics derived from the Actigraph GT3X in multiple sclerosis: A rapid review and comparative study.

Polhemus A, Haag C, Sieber C, Sylvester R, Kool J, Gonzenbach R Front Rehabil Sci. 2022; 3:989658.

PMID: 36518351 PMC: 9742246. DOI: 10.3389/fresc.2022.989658.

Bright light therapy as a non-pharmacological treatment option for multiple sclerosis-related fatigue: A randomized sham-controlled trial.

Voggenberger L, Bock M, Moser D, Lorbeer G, Altmann P, Leutmezer F Mult Scler J Exp Transl Clin. 2022; 8(4):20552173221133262.

PMID: 36387033 PMC: 9647309. DOI: 10.1177/20552173221133262.

Physical activity dimensions after stroke: patterns and relation with lower limb motor function.

Braakhuis H, Berger M, Regterschot R, van Wegen E, Selles R, Ribbers G J Neuroeng Rehabil. 2021; 18(1):171.

PMID: 34895265 PMC: 8666008. DOI: 10.1186/s12984-021-00960-x.

Physical activity profiles in Parkinson's disease.

Von Rosen P, Hagstromer M, Franzen E, Leavy B BMC Neurol. 2021; 21(1):71.

PMID: 33581724 PMC: 7881685. DOI: 10.1186/s12883-021-02101-2.

References

de Groot V, Beckerman H, Twisk J, Uitdehaag B, Hintzen R, Minneboo A . Vitality, perceived social support and disease activity determine the performance of social roles in recently diagnosed multiple sclerosis: a longitudinal analysis. J Rehabil Med. 2008; 40(2):151-7. DOI: 10.2340/16501977-0145. View

Stuke K, Flachenecker P, Zettl U, Elias W, Freidel M, Haas J . Symptomatology of MS: results from the German MS Registry. J Neurol. 2009; 256(11):1932-5. DOI: 10.1007/s00415-009-5257-5. View

Chastin S, Granat M . Methods for objective measure, quantification and analysis of sedentary behaviour and inactivity. Gait Posture. 2009; 31(1):82-6. DOI: 10.1016/j.gaitpost.2009.09.002. View

Daumer M, Neuhaus A, Herbert J, Ebers G . Prognosis of the individual course of disease: the elements of time, heterogeneity and precision. J Neurol Sci. 2010; 287 Suppl 1:S50-5. DOI: 10.1016/S0022-510X(09)71301-2. View

van Stralen M, de Vries H, Mudde A, Bolman C, Lechner L . The long-term efficacy of two computer-tailored physical activity interventions for older adults: main effects and mediators. Health Psychol. 2011; 30(4):442-52. DOI: 10.1037/a0023579. View

Motl R, Pilutti L, Sandroff B, Dlugonski D, Sosnoff J, Pula J . Accelerometry as a measure of walking behavior in multiple sclerosis. Acta Neurol Scand. 2012; 127(6):384-90. DOI: 10.1111/ane.12036. View

Latimer-Cheung A, Pilutti L, Hicks A, Martin Ginis K, Fenuta A, MacKibbon K . Effects of exercise training on fitness, mobility, fatigue, and health-related quality of life among adults with multiple sclerosis: a systematic review to inform guideline development. Arch Phys Med Rehabil. 2013; 94(9):1800-1828.e3. DOI: 10.1016/j.apmr.2013.04.020. View

Bussmann J, van den Berg-Emons R . To total amount of activity….. and beyond: perspectives on measuring physical behavior. Front Psychol. 2013; 4:463. PMC: 3717476. DOI: 10.3389/fpsyg.2013.00463. View

Beckerman H, Blikman L, Heine M, Malekzadeh A, Teunissen C, Bussmann J . The effectiveness of aerobic training, cognitive behavioural therapy, and energy conservation management in treating MS-related fatigue: the design of the TREFAMS-ACE programme. Trials. 2013; 14:250. PMC: 3751829. DOI: 10.1186/1745-6215-14-250. View

10.

Kister I, Bacon T, Chamot E, Salter A, Cutter G, Kalina J . Natural history of multiple sclerosis symptoms. Int J MS Care. 2014; 15(3):146-58. PMC: 3883021. DOI: 10.7224/1537-2073.2012-053. View

11.

Rietberg M, van Wegen E, Kollen B, Kwakkel G . Do Patients With Multiple Sclerosis Show Different Daily Physical Activity Patterns From Healthy Individuals?. Neurorehabil Neural Repair. 2014; 28(6):516-23. DOI: 10.1177/1545968313520412. View

12.

Browne P, Chandraratna D, Angood C, Tremlett H, Baker C, Taylor B . Atlas of Multiple Sclerosis 2013: A growing global problem with widespread inequity. Neurology. 2014; 83(11):1022-4. PMC: 4162299. DOI: 10.1212/WNL.0000000000000768. View

13.

Blikman L, van Meeteren J, Horemans H, Kortenhorst I, Beckerman H, Stam H . Is physical behavior affected in fatigued persons with multiple sclerosis?. Arch Phys Med Rehabil. 2014; 96(1):24-9. DOI: 10.1016/j.apmr.2014.08.023. View

14.

Motl R, McAuley E, Sandroff B, Hubbard E . Descriptive epidemiology of physical activity rates in multiple sclerosis. Acta Neurol Scand. 2015; 131(6):422-5. DOI: 10.1111/ane.12352. View

15.

Wallen M, Franzen E, Nero H, Hagstromer M . Levels and Patterns of Physical Activity and Sedentary Behavior in Elderly People With Mild to Moderate Parkinson Disease. Phys Ther. 2015; 95(8):1135-41. DOI: 10.2522/ptj.20140374. View

16.

English C, Healy G, Coates A, Lewis L, Olds T, Bernhardt J . Sitting and Activity Time in People With Stroke. Phys Ther. 2015; 96(2):193-201. DOI: 10.2522/ptj.20140522. View

17.

Achterkamp R, Dekker-Van Weering M, Evering R, Tabak M, Timmerman J, Hermens H . Strategies to improve effectiveness of physical activity coaching systems: Development of personas for providing tailored feedback. Health Informatics J. 2016; 24(1):92-102. DOI: 10.1177/1460458216653242. View

18.

Paraschiv-Ionescu A, Perruchoud C, Rutschmann B, Buchser E, Aminian K . Quantifying dimensions of physical behavior in chronic pain conditions. J Neuroeng Rehabil. 2016; 13(1):85. PMC: 5035446. DOI: 10.1186/s12984-016-0194-x. View

19.

Kasser S, Goldstein A, Wood P, Sibold J . Symptom variability, affect and physical activity in ambulatory persons with multiple sclerosis: Understanding patterns and time-bound relationships. Disabil Health J. 2016; 10(2):207-213. DOI: 10.1016/j.dhjo.2016.10.006. View

20.

Newland P, Lunsford V, Flach A . The interaction of fatigue, physical activity, and health-related quality of life in adults with multiple sclerosis (MS) and cardiovascular disease (CVD). Appl Nurs Res. 2017; 33:49-53. DOI: 10.1016/j.apnr.2016.09.001. View