Three distinct physical behavior types in fatigued patients with multiple sclerosis.
H E M Braakhuis, M A M Berger, G A van der Stok and 4 others
PMID 31443714WHAT IT FOUND
Fatigued MS patients with similar fatigue scores fell into different daily activity profiles.
One was mostly sedentary, one was less sedentary in the afternoon, and one was most active. Fatigue scores were similar across the profiles.
Key findings
01Three physical behavior clusters were identified among the analysed patients, with 46, 114, and 48 patients.
02The clusters differed in daily activity: the largest cluster had the highest sedentary behavior, and another cluster had the highest total time in moderate-to-vigorous activity.
03Fatigue scores did not differ between the clusters.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The data were cross-sectional baseline measures, so the paper cannot show that physical behavior caused fatigue or that fatigue caused physical behavior. The sample was selected for severe fatigue, EDSS below 6, and no depression, so it may not apply to MS patients with milder fatigue, more disability, or depression. The study did not test an intervention, so it does not show that treating a cluster differently improves fatigue or activity. The accelerometer measures were limited to what the device could calculate, so specific postures and movements such as sitting, walking, cycling, and running were not measured. Four patients with extreme values were excluded, leaving 212 of 266 baseline participants analysed. The day pattern measures are relative change scores and partly overlap because both include afternoon sedentary behavior.
Declared interests
The paper states that the study was funded by NutsOhra. No other conflict of interest declaration is provided.
The easy way to misread this
Do not read this as evidence that fatigue causes sedentary behavior or that a cluster-matched intervention will reduce fatigue. The study was cross-sectional and did not test treatment.