BIOMED, Hasselt University, Diepenbeek and REVAL Research Institute, PHL University College, Hasselt, Belgium.
Mult Scler. 2012 Mar;18(3):351-7. doi: 10.1177/1352458511419881. Epub 2011 Oct 3.
Many persons with multiple sclerosis (PwMS) report increased fatigue in the afternoon and evening compared with the morning. It is commonly accepted that physical capacity also decreases as time of day progresses, potentially influencing the outcomes of testing.
The objective of this article was to determine whether self-reported fatigue level and walking capacity are influenced by time of day in PwMS.
A total of 102 PwMS from 8 centers in 5 countries, with a diverse level of ambulatory dysfunction (Expanded Disability Status Scale [EDSS] <6.5), participated. Patients performed walking capacity tests and reported fatigue level at three different time points (morning, noon, afternoon) during 1 day. Walking capacity was measured with the 6-Minute Walk Test (6MWT) and the 10-m walk test performed at usual and fastest speed. Self-reported fatigue was measured by the Rochester Fatigue Diary (RFD). Subgroups with mild (EDSS 1.5-4.0, n = 53) and moderate (EDSS 4.5-6.5, n = 49) ambulatory dysfunction were formed, as changes during the day were hypothesized to depend on disability status.
Subgroups had different degree of ambulatory dysfunction (p < 0.001) but reported similar fatigue levels. Although RFD scores were affected by time of day with significant differences between morning and noon/afternoon (p < 0.0001), no changes in walking capacity were found in any subgroup. Additional analyses on subgroups distinguished by diurnal change in self-reported fatigue failed to reveal analogous changes in walking capacity.
Testing of walking capacity is unaffected by time of day, despite changes in subjective fatigue.
许多多发性硬化症（MS）患者报告称，与早上相比，下午和晚上疲劳感会增加。人们普遍认为，随着时间的推移，身体能力也会下降，这可能会影响测试结果。
本文旨在确定多发性硬化症患者的自我报告疲劳水平和行走能力是否受时间的影响。
共有来自 5 个国家 8 个中心的 102 名多发性硬化症患者参与了这项研究，他们的步行功能障碍程度不同（扩展残疾状况量表 [EDSS] <6.5）。患者在一天中的三个不同时间点（早晨、中午、下午）进行了行走能力测试和疲劳水平报告。行走能力通过 6 分钟步行测试（6MWT）和以通常速度和最快速度进行的 10 米步行测试进行测量。自我报告的疲劳通过罗切斯特疲劳日记（RFD）进行测量。形成了轻度（EDSS 1.5-4.0，n=53）和中度（EDSS 4.5-6.5，n=49）步行功能障碍亚组，因为假设日间变化取决于残疾状况。
亚组的步行功能障碍程度不同（p<0.001），但报告的疲劳水平相似。尽管 RFD 评分受到时间的影响，早晨和中午/下午之间存在显著差异（p<0.0001），但在任何亚组中都未发现行走能力的变化。对自我报告疲劳日间变化的亚组进行的额外分析未能揭示行走能力的类似变化。
尽管主观疲劳感发生变化，但行走能力的测试不受时间的影响。
