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Journal of NeuroEngineering and Rehabilitation

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Open Access 01-12-2019 | Multiple Sclerosis | Research

Three distinct physical behavior types in fatigued patients with multiple sclerosis

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, on behalf of the TREFAMS-ACE study group

Published in: Journal of NeuroEngineering and Rehabilitation | Issue 1/2019

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.

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Title: Three distinct physical behavior types in fatigued patients with multiple sclerosis
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
on behalf of the TREFAMS-ACE study group
Publication date: 01-12-2019
Publisher: BioMed Central
Keywords: Multiple Sclerosis
Fatigue
Published in: Journal of NeuroEngineering and Rehabilitation / Issue 1/2019
Electronic ISSN: 1743-0003
DOI: https://doi.org/10.1186/s12984-019-0573-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Three distinct physical behavior types in fatigued patients with multiple sclerosis

Abstract

Background

Methods

Results

Conclusions

Trial registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Trial registration

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