Department of Interdisciplinary Health Sciences, Augusta University, Augusta, Georgia, USA.
Augusta VMAC, Augusta, Georgia, USA.
J Transl Med. 2018 Jul 11;16(1):192. doi: 10.1186/s12967-018-1554-z.
Fatigue is a common problem among individuals with Parkinson's disease (PD). It may occur before the overt symptoms of bradykinesia, rigidity and tremor. Little is understood about how to measure fatigue in PD. Here we determined the dimensionality of the constructs of fatigue.
Four recommended scales, the Fatigue Severity Scale, Functional Assessment of Chronic Illness Therapy-Fatigue, Parkinson Fatigue Scale and Visual Analog Fatigue Scale (VAFS) were tested against quality of life measures including cognition, depression, sleep, life orientation, physical activity and PD symptoms in 22 PD subjects and 15 caregivers.
Fatigue was associated with many quality of life variables, with the PDQ-39 summary index showing the strongest association. PD subjects agreed more strongly than caregivers that they experienced higher levels of fatigue. 27% of PD subjects rated fatigue as one of their top three most bothersome symptoms. The constructs of fatigue was captured within one dimension which explained 67% of the total variance, of which the VAFS showed the highest internal consistency. The highest likelihood ratio gave a cut-off score of < 5.5 on the VAFS. The change in scores required to produce a perceptible difference or is grossly observable ranged between 1.4 and 2.2 points respectively.
The potential utility of a single measure such as the VAFS in PD that is reliably correlated with quality of life is consistent with the pursuit to develop clinical tests and measurements that are accessible, easy to use and universally interpretable across health science disciplines.
疲劳是帕金森病（PD）患者的常见问题。它可能在运动迟缓、僵硬和震颤等明显症状出现之前就已经发生。对于如何测量 PD 患者的疲劳，我们知之甚少。在这里，我们确定了疲劳结构的维度。
我们对四个推荐量表，即疲劳严重程度量表、慢性疾病治疗功能评估-疲劳量表、帕金森疲劳量表和视觉模拟疲劳量表（VAFS）进行了测试，这些量表与认知、抑郁、睡眠、生活取向、身体活动和 PD 症状等生活质量指标相对比，共纳入了 22 名 PD 患者和 15 名护理人员。
疲劳与许多生活质量变量有关，PDQ-39 综合指数与疲劳的相关性最强。PD 患者比护理人员更强烈地认为他们经历了更高水平的疲劳。27%的 PD 患者将疲劳列为他们最困扰的三大症状之一。疲劳的结构可以用一个维度来描述，该维度解释了总方差的 67%，其中 VAFS 显示出最高的内部一致性。最高似然比给出的 VAFS 截断值为<5.5。要产生可察觉的差异或明显变化，所需的分数变化范围分别在 1.4 到 2.2 分之间。
VAFS 等单一测量工具在 PD 中的潜在效用与生活质量密切相关，这与开发易于获取、使用方便且在整个健康科学领域都具有普遍解释意义的临床测试和测量方法的目标是一致的。
