Trojan D A, Arnold D, Collet J-P, Shapiro S, Bar-Or A, Robinson A, Le Cruguel J-P, Ducruet T, Narayanan S, Arcelin K, Wong A N, Tartaglia M C, Lapierre Y, Caramanos Z, Da Costa D
Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University Health Centre, McGill University, Montreal, Quebec, Canada.
Mult Scler. 2007 Sep;13(8):985-95. doi: 10.1177/1352458507077175. Epub 2007 Apr 27.
We determined biopsychosocial correlates of general, physical, and mental fatigue in MS patients, by evaluating the additional contribution of potentially modifiable factors after accounting for non-modifiable disease-related factors. Fifty-three ambulatory MS patients, along with 28 normal controls were recruited for a cross-sectional study. Subjects completed the Multidimensional Fatigue Inventory (MFI) and Fatigue Severity Scale. Potential correlates evaluated were: disease-related factors (disease duration and type, immunomodulating treatment, muscle strength, pain, forced vital capacity (FVC), respiratory muscle strength, body mass index, disability, fibromyalgia), behavioural factors (physical activity, sleep quality) and psychosocial factors (depression, stress, self-efficacy). Multivariate models were calculated for MFI General, Physical, and Mental Fatigue. Age-adjusted multivariate models with non-modifiable factors included the following predictors (P < or = 0.10) of 1) MFI General and Mental Fatigue: none; and 2) MFI Physical Fatigue: FVC and disability. The following potentially modifiable predictors (P < or = 0.10) made an additional contribution to the models 1) MFI General Fatigue: sleep quality, self-efficacy, pain; 2) MFI Physical Fatigue: self-efficacy, physical activity; and 3) MFI Mental Fatigue: stress, self-efficacy. Fatigue in MS is multidimensional. Correlates of general and physical fatigue are disease-related, behavioural and psychosocial factors. Correlates of mental fatigue are psychosocial factors. Potentially modifiable factors account for a considerable portion of fatigue.
我们通过评估在考虑了不可改变的疾病相关因素后潜在可改变因素的额外作用，确定了多发性硬化症（MS）患者中一般疲劳、身体疲劳和精神疲劳的生物心理社会相关因素。招募了53名非卧床MS患者以及28名正常对照进行横断面研究。受试者完成了多维疲劳量表（MFI）和疲劳严重程度量表。评估的潜在相关因素包括：疾病相关因素（疾病持续时间和类型、免疫调节治疗、肌肉力量、疼痛、用力肺活量（FVC）、呼吸肌力量、体重指数、残疾、纤维肌痛）、行为因素（身体活动、睡眠质量）和心理社会因素（抑郁、压力、自我效能感）。计算了MFI一般疲劳、身体疲劳和精神疲劳的多变量模型。包含不可改变因素的年龄调整多变量模型包括以下预测因素（P≤0.10）：1）MFI一般疲劳和精神疲劳：无；2）MFI身体疲劳：FVC和残疾。以下潜在可改变的预测因素（P≤0.10）对模型有额外贡献：1）MFI一般疲劳：睡眠质量、自我效能感、疼痛；2）MFI身体疲劳：自我效能感、身体活动；3）MFI精神疲劳：压力、自我效能感。MS中的疲劳是多维度的。一般疲劳和身体疲劳的相关因素是疾病相关、行为和心理社会因素。精神疲劳的相关因素是心理社会因素。潜在可改变因素占疲劳的相当一部分。
