Gulde Philipp, Rieckmann Peter
Center for Clinical Neuroplasticity, Medical Park Loipl, Medical Park Societas Europaea, Bischofswiesen, Germany.
Human Movement Science, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany.
JMIR Rehabil Assist Technol. 2022 Mar 17;9(1):e31164. doi: 10.2196/31164.
Persons with multiple sclerosis frequently report increased levels of fatigue and fatigability. However, behavioral surrogates that are strongly associated with self-reports are lacking, which limits research and treatment.
The aim of this study was to derive distinct behavioral syndromes that are reflected by self-reports concerning fatigue and fatigability.
We collected actigraphic data of 30 persons with multiple sclerosis over a period of 1 week during an inpatient stay at a neurorehabilitation facility. Further, participants completed the German fatigue severity scale. A principal component analysis of actigraphic parameters was performed to extract the latent component levels of behaviors that reflect fatigue (quantity of activity) and fatigability (fragmentation of activity). The resulting components were used in a cluster analysis.
Analyses suggested 3 clusters, one with high activity (d=0.65-1.57) and low clinical disability levels (d=0.91-1.39), one with high levels of sedentary behavior (d=1.06-1.58), and one with strong activity fragmentation (d=1.39-1.94). The cluster with high levels of sedentary behavior further revealed strong differences from the other clusters concerning participants' reported levels of fatigue (d=0.99-1.28).
Cluster analysis data proved to be feasible to meaningfully differentiate between different behavioral syndromes. Self-reports reflected the different behavioral syndromes strongly. Testing of additional domains (eg, volition or processing speed) and assessments during everyday life seem warranted to better understand the origins of reported fatigue symptomatology.
多发性硬化症患者经常报告疲劳和易疲劳程度增加。然而，缺乏与自我报告密切相关的行为替代指标，这限制了研究和治疗。
本研究的目的是得出由关于疲劳和易疲劳的自我报告所反映的不同行为综合征。
我们收集了30名多发性硬化症患者在神经康复机构住院期间1周内的活动记录仪数据。此外，参与者完成了德国疲劳严重程度量表。对活动记录仪参数进行主成分分析，以提取反映疲劳（活动量）和易疲劳（活动碎片化）的潜在行为成分水平。所得成分用于聚类分析。
分析表明有3个聚类，一个聚类活动量高（d=0.65-1.57）且临床残疾水平低（d=0.91-1.39），一个聚类久坐行为水平高（d=1.06-1.58），一个聚类活动碎片化严重（d=1.39-1.94）。久坐行为水平高的聚类在参与者报告的疲劳水平方面与其他聚类也有明显差异（d=0.99-1.28）。
聚类分析数据被证明可有效区分不同的行为综合征。自我报告强烈反映了不同的行为综合征。对其他领域（如意志力或处理速度）进行测试以及在日常生活中进行评估，似乎有助于更好地理解所报告疲劳症状的根源。
