REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Limburg, Belgium.
UMSC University MS Center Hasselt Pelt, Hasselt Pelt, Belgium.
Neurorehabil Neural Repair. 2024 May;38(5):327-338. doi: 10.1177/15459683241236161. Epub 2024 Mar 1.
People with progressive multiple sclerosis (PMS) present motor (eg, walking) and cognitive impairments, and report fatigue. Fatigue encompasses fatigability which is objectively measured by the capacity to sustain a motor or cognitive task.
To investigate the prevalence of walking and cognitive fatigability (CF) and the associated clinical characteristics in a large sample of PMS patients.
PMS patients (25-65 years old) were included from 11 sites (Europe and North America), having cognitive impairment (1.28 standard deviation below normative data for the symbol digit modality test [SDMT]). Walking fatigability (WF) was assessed using the distance walk index (DWI) and CF using the SDMT (scores from the last 30 seconds compared to the first 30 seconds). Additional measures were: cognitive assessment-Brief International Cognitive Assessment for multiple sclerosis (MS), cardiorespiratory fitness, 6-minute walk, physical activity, depressive symptoms, perceived fatigue-Modified Fatigue Impact Scale (MFIS), MS impact-MSIS-29, and walking ability.
Of 298 participants, 153 (51%) presented WF (DWI = -28.9 ± 22.1%) and 196 (66%) presented CF (-29.7 ± 15%). Clinical characteristics (EDSS, disease duration, and use of assistive device) were worse in patients with versus without WF. They also presented worse scores on MSIS-29 physical, MFIS total and physical and reduced physical capacity. CF patients scored better in the MSIS-29 physical and MFIS psychosocial, compared to non-CF group. Magnitude of CF and WF were not related.
Half of the cognitively-impaired PMS population presented WF which was associated with higher disability, physical functions, and fatigue. There was a high prevalence of CF but without strong associations with clinical, cognitive, and physical functions.
The "CogEx-study," www.clinicaltrial.gov identifier number: NCT03679468.
进展性多发性硬化症（PMS）患者存在运动（例如行走）和认知障碍，并伴有疲劳。疲劳包括疲劳感，可通过持续进行运动或认知任务的能力来客观测量。
在大量 PMS 患者中，研究行走和认知疲劳（CF）的发生率及其相关临床特征。
从 11 个地点（欧洲和北美）纳入 PMS 患者（25-65 岁），这些患者认知障碍（符号数字模态测试 [SDMT] 的正常数据低 1.28 个标准差）。使用距离步行指数（DWI）评估行走疲劳（WF），使用 SDMT 评估 CF（与前 30 秒相比，最后 30 秒的分数）。其他测量指标包括：认知评估-多发性硬化症简短国际认知评估（MS）、心肺功能适应性、6 分钟步行、身体活动、抑郁症状、感知疲劳-修改后的疲劳影响量表（MFIS）、多发性硬化症影响-多发性硬化症影响量表 29 项（MSIS-29）和行走能力。
在 298 名参与者中，153 名（51%）存在 WF（DWI=-28.9±22.1%），196 名（66%）存在 CF（-29.7±15%）。与无 WF 患者相比，存在 WF 的患者的临床特征（EDSS、疾病持续时间和使用辅助设备）更差。他们在 MSIS-29 身体、MFIS 总分和身体以及身体能力降低方面的评分也更低。与非 CF 组相比，CF 患者在 MSIS-29 身体和 MFIS 心理社会方面的评分更高。CF 和 WF 的严重程度没有关系。
一半的认知受损 PMS 患者存在 WF，这与更高的残疾、身体功能和疲劳有关。CF 的患病率很高，但与临床、认知和身体功能没有很强的关联。
“CogEx 研究”，www.clinicaltrial.gov 标识符号：NCT03679468。
