- •Fatigued persons with multiple sclerosis are less physically active than healthy controls during the whole day.
- •Persons with multiple sclerosis are especially less active in the morning and evening.
- •Persons with multiple sclerosis spend more time sedentary and less time at higher-intensity physical activity than healthy controls.
- •Persons with multiple sclerosis have longer sedentary periods and shorter high-intensity periods.
- •Detailed measures may provide more insight into how multiple sclerosis affects physical behavior.
To study physical behavior in detail in fatigued persons with multiple sclerosis (MS).
Case-control explorative study.
Outpatient rehabilitation department and participants' daily environment.
Fatigued persons with MS (n=23) were selected from a randomized controlled trial. Cases were matched by age and sex to healthy, nonfatigued controls (n=23). Eligible persons with MS were severely fatigued (Checklist Individual Strength fatigue domain mean score, 43.2±6.6) and ambulatory (Expanded Disability Status Scale mean score, 2.5±1.5).
Main Outcome Measures
Measurements were performed using an accelerometer over 7 days. Outcomes included the following: amount of physical activity expressed in counts per day, counts per minute (CPM), and counts per day period (morning, afternoon, evening); duration of activity intensity categories (sedentary, light physical activity, moderate-to-vigorous physical activity [MVPA]); and distribution of MVPA and sedentary periods over the day.
Persons with MS had fewer counts per day (mean difference, −156×103; 95% confidence interval [CI], −273×103 to −39×103; P=.010), had fewer CPM (mean difference, −135; 95% CI, −256 to −14; P=.030), and were less physically active in the morning (mean difference, −200; 95% CI, −389 to −11; P=.039) and evening (mean difference, −175; 95% CI, −336 to −14; P=.034) than controls. Persons with MS spent a higher percentage of their time sedentary (mean difference, 5.6; 95% CI, .1–11.1; P=.045) and spent less time at the higher MVPA intensity (mean difference, −2.4; 95% CI, −4.7 to −0.09; P=.042). They had fewer MVPA periods (mean difference, 29; 95% CI, −56.2 to −2.6; P=.032) and a different distribution of sedentary (mean difference, .033; 95% CI, .002 to .064; P=.039) and MVPA periods (mean difference, −.08; 95% CI, −.15 to −.01; P=.023).
Detailed analyses of physical behavior showed that ambulatory fatigued persons with MS do differ from healthy controls not only in physical activity level, but also in other physical behavior dimensions (eg, day patterns, intensity, distribution).
List of abbreviations:CI (confidence interval), CPM (counts per minute), MS (multiple sclerosis), MVPA (moderate-to-vigorous physical activity)
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Published online: September 17, 2014
This study is part of the Dutch Treating Fatigue in Multiple Sclerosis with Aerobic Training, Cognitive Behavioral Therapy and Energy Conservation Management Research Program. Supported by Fonds NutsOhra (grant no. 89000005).
Clinical Trial Registration No.: ISRCTN 82353628.
© 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.