Is physical behavior affected in fatigued persons with multiple sclerosis?: Physical behavior in multiple sclerosis

Objective: To study physical behavior (PB) in detail in fatigued persons with multiple sclerosis (MS). Design: case-control explorative study.

Setting: Outpatient rehabilitation department. PB monitoring was conducted in participants’ daily environment.

Participants: Twenty-three fatigued persons with MS were selected from an RCT. Cases were matched to, 23 age- and gender-matched healthy, non-fatigued controls. Eligible persons with MS were severely fatigued (Checklist Individual Strength (CIS20R) domain fatigue, mean score 43.2 ± 6.6) and ambulatory (EDSS mean score 2.5 ± 1.5).

Interventions: not applicable MAIN OUTCOME MEASURES: Measurements were performed using an accelerometer over seven days. Outcomes included: 1) amount of physical activity (PA) expressed in counts per day (CPD) and counts per minute (CPM), and per day period (morning, afternoon, evening); 2) duration of activity intensity categories (sedentary, light, and moderate-to-vigorous physical activity (MVPA)); and 3) distribution of MVPA and sedentary periods over the day.

Results: Persons with MS had fewer CPD (mean difference -156×103, 95% CI [-273 ×103, -39 ×103], p=0.010), and CPM (-135,[-256, -14], p=0.030), and were less physically active in the morning (-200,[-389, -11], p=0.039) and evening (-175,[-336,-14], p=0.034) compared to controls. Persons with MS spent a higher percentage of their time sedentary (5.6,[0.1, 11.1], p=0.045) and less time at the higher MVPA intensity (-2.4,[-4.7, -0.09], p=0.042). They had fewer MVPA periods (-29,[-56.2, -2.6], p=0.032) and a different distribution of sedentary (0.033,[0.002, 0.064], p=0.039) and MVPA periods (-0.08,[-0.15, -0.01], p=0.023).

Conclusions: Detailed analyses of PB showed that ambulatory fatigued persons with MS do differ from healthy controls not only in physical activity level, but also in other PB dimensions such as day patterns, intensity and distribution.