The relationship between fatigue and patterns of physical activity in people with multiple sclerosis (MS) is not straightforward. New findings show that, among MS patients with similar fatigue levels, there are three different types — or “clusters” — of physical behavior.
Clinicians should be aware of these behavioral types as they could be useful in developing personalized rehabilitation programs for individuals with MS, researchers say.
The study, “Three distinct physical behavior types in fatigued patients with multiple sclerosis,” was published in the Journal of NeuroEngineering and Rehabilitation.
Fatigue is a common symptom experienced by the majority — more than 80% — of MS patients. While it is believed to induce changes in people’s physical behavior, previous studies have described only a weak association between MS-related fatigue and physical activity patterns.
Researchers believe that, like the variability in symptoms, response to exercise is also highly heterogeneous in people with MS. So, a better understanding of how MS physical behavior varies could help healthcare professionals develop personalized interventions that could greatly improve MS management and patients’ quality of life.
To learn more, Dutch researchers analyzed data from the TREFAMS-ACE program, which included three clinical trials — ISRCTN82353628, ISRCTN69520623, and ISRCTN58583714. These trials evaluated the impact of different rehabilitation strategies — specifically aerobic training, cognitive behavioral therapy, and energy conservation management — on the outcomes of people with MS.
The team reviewed the clinical data of 212 adults with MS enrolled in the program (mean age of 47.9 years) who showed symptoms of severe fatigue, as determined by a score higher than 35 in the Checklist Individual Strength scale. All were still able to walk, and their disability score, as measured by Expanded Disability Status Scale (EDSS), was below 6 (indicating less severe disability). Most patients (73.1%) had relapsing-remitting MS.
Researchers used accelerometer signals to distinguish between sedentary, light, and moderate/vigorous physical activity — both in terms of amount and intensity, frequency and duration. They also recorded activity patterns during the day, to measure the MS patients’ physical behavior.
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