Is Physical Behavior Affected in Fatigued Persons With Multiple Sclerosis?

• Published in: Archives of physical medicine and rehabilitation Vol. 96; no. 1; pp. 24 - 29
• Main Authors: Blikman, Lyan J., MSc, van Meeteren, Jetty, MD, PhD, Horemans, Herwin L., PhD, Kortenhorst, Ilse C., BSc, Beckerman, Heleen, PT, PhD, Stam, Henk J., MD, PhD, FRCP, Bussmann, Johannes B., PT, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 2015
• Subjects: Accelerometry; Adult; Aged; Case-Control Studies; Exercise; Fatigue - epidemiology; Female; Humans; Male; Middle Aged; Motor activity; Multiple sclerosis; Multiple Sclerosis - epidemiology; Multiple Sclerosis - rehabilitation; Physical Medicine and Rehabilitation; Rehabilitation; Sedentary Lifestyle; Time Factors; CPM; Multiple sclerosis; counts per minute; Motor activity; CI; MS; moderate-to-vigorous physical activity; Sedentary lifestyle; confidence interval; Rehabilitation; MVPA
• ISSN: 0003-9993; 1532-821X
• DOI: 10.1016/j.apmr.2014.08.023

Abstract Objective To study physical behavior in detail in fatigued persons with multiple sclerosis (MS). Design Case-control explorative study. Setting Outpatient rehabilitation department and participants' daily environment. Participants Fatigued persons with MS (n=23) were selected from a randomized controlled trial. Cases were matched by age and sex to healthy, nonfatigued controls (n=23). Eligible persons with MS were severely fatigued (Checklist Individual Strength fatigue domain mean score, 43.2±6.6) and ambulatory (Expanded Disability Status Scale mean score, 2.5±1.5). Interventions Not applicable. Main Outcome Measures Measurements were performed using an accelerometer over 7 days. Outcomes included the following: amount of physical activity expressed in counts per day, counts per minute (CPM), and counts per day period (morning, afternoon, evening); duration of activity intensity categories (sedentary, light physical activity, moderate-to-vigorous physical activity [MVPA]); and distribution of MVPA and sedentary periods over the day. Results Persons with MS had fewer counts per day (mean difference, −156×103 ; 95% confidence interval [CI], −273×103 to −39×103 ; P =.010), had fewer CPM (mean difference, −135; 95% CI, −256 to −14; P =.030), and were less physically active in the morning (mean difference, −200; 95% CI, −389 to −11; P =.039) and evening (mean difference, −175; 95% CI, −336 to −14; P =.034) than controls. Persons with MS spent a higher percentage of their time sedentary (mean difference, 5.6; 95% CI, .1–11.1; P =.045) and spent less time at the higher MVPA intensity (mean difference, −2.4; 95% CI, −4.7 to −0.09; P =.042). They had fewer MVPA periods (mean difference, 29; 95% CI, −56.2 to −2.6; P =.032) and a different distribution of sedentary (mean difference, .033; 95% CI, .002 to .064; P =.039) and MVPA periods (mean difference, −.08; 95% CI, −.15 to −.01; P =.023). Conclusions Detailed analyses of physical behavior showed that ambulatory fatigued persons with MS do differ from healthy controls not only in physical activity level, but also in other physical behavior dimensions (eg, day patterns, intensity, distribution).