Ecological Momentary Assessment of Pain, Fatigue, Depressive, and Cognitive Symptoms Reveals Significant Daily Variability in Multiple Sclerosis.
Anna L Kratz, Susan L Murphy, Tiffany J Braley
PMID 28729168WHAT IT FOUND
In ambulatory multiple sclerosis, pain, fatigue, depressed mood, and perceived cognitive function increased significantly from wake to bedtime.
Fatigue varied most within the day, depressed mood least, and fatigue patterns differed by age and sex.
Key findings
01All four symptoms increased significantly from wake to bedtime.
02Fatigue had the largest share of within-person variability, at 50%, while depressed mood had the smallest, at 31%.
03The oldest group (53-67 years) showed a steep rise in fatigue from 3PM to 7PM, while women peaked at bedtime and men plateaued at 7PM.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
Only ambulatory individuals were included because the study used an accelerometer, so the findings may not apply to people with MS who need more assistance to walk. The EMA symptom items were single-item measures developed for this study and were not previously validated. The sample was relatively small, which limited modeling of individual differences and total symptom burden. Other common MS symptoms, such as weakness and sensory disturbances, were not assessed. Average EMA ratings were low compared with baseline standardized measures, and the reason for this difference was not resolved.
Declared interests
The authors declared no conflicts of interest. The article is tagged as supported by extramural NIH research.
The easy way to misread this
Do not use these daily ratings as a validated clinical assessment tool. They were single-item measures developed for this study and were not previously validated, although they agreed well with end-of-day diaries.