A Comparison of Fatigue Scales in Postpoliomyelitis Syndrome
Presented in part to the American Academy of Neurology, April 2005, Miami, FL.
Abstract
Vasconcelos Jr OM, Prokhorenko OA, Kelley KF, Vo AH, Olsen CH, Dalakas MC, Halstead LS, Jabbari B, Campbell WW. A comparison of fatigue scales in postpoliomyelitis syndrome.
Objective
To examine the applicability and validity of traditional fatigue questionnaires in postpoliomyelitis syndrome (PPS) patients with disabling fatigue.
Design
Cross-sectional study. PPS and disabling fatigue were ascertained according to published criteria. Descriptiveness was determined using the McNemar test, and interscale z-score agreement was estimated with Pearson’s coefficients.
Setting
PPS clinic.
Participants
Fifty-six survivors of poliomyelitis: 39 met criteria for PPS, 25 of whom met criteria for disabling fatigue.
Interventions
Not applicable.
Main Outcome Measures
The Fatigue Severity Scale (FSS), visual analog scale (VAS) for fatigue, and Fatigue Impact Scale (FIS).
Results
Twenty-four patients scored 50% or higher on the scale range for FSS, compared with 19 patients for VAS for fatigue (P=.042), and 7 patients for FIS (P<.001). Scores for patients with disabling fatigue averaged 81.5%, 62%, and 40.9% of the scale range for FSS, VAS for fatigue, and FIS, respectively. Agreement was moderate between the FSS and VAS for fatigue (r=.45, P=.02), but low between FSS and FIS (r=.29, P=.15), and FIS and VAS for fatigue (r=.20, P=.33). Two sample t tests showed significant differences between those with disabling fatigue and those without, based on FSS scores (t=3.8, P<.001), but not for VAS for fatigue or FIS scores.
Conclusions
FSS was the most descriptive of the instruments tested. Scores generated by the scales were not interchangeable. Of the 3 scales, FFS seemed to be the most informative for the clinical assessment of fatigue in patients with PPS.
aDepartment of Neurology, Uniformed Services University of the Health Sciences, Bethesda, MD
bNeuromuscular Diseases Section, National Institutes of Health, Bethesda, MD
cNeuroscience Department, National Rehabilitation Hospital, Washington, DC
Reprint requests to Olavo M. Vasconcelos Jr, MD, 4301 Jones Bridge Rd, Bldg 53/Rm 101, Bethesda, MD 20814
Supported by the Department of Defense (Health Affairs grant no. MDA 905-01-007).
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.
ABSTRACT