Multiple sclerosis (MS) is an autoimmune disease affecting approximately 2.3 million
people worldwide.1 Fatigue occurs in approximately 80% of individuals with MS.2 The Modified Fatigue Impact Scale (MFIS) is a modified form of the Fatigue Impact
Scale,3 based on items derived from interviews with patients with MS concerning how fatigue
affects their lives. The full-length MFIS has 21 items, whereas the short version
has 5 items. The full-length version generates 3 subscales (physical, cognitive, and
psychosocial functioning), which assess the perceived effect of fatigue during the
last 4 weeks.4 Participants rate the MFIS on a 5-point Likert scale from 0 (never) to 4 (almost
always). Total scores range from 0 to 84; for the subscale scores, the physical subscale
ranges from 0 to 36, the cognitive subscale ranges from 0 to 40, and the psychosocial
functioning subscale ranges from 0 to 8. The scores range from 0 to 20 for the 5-item
version. Higher numbers indicate greater fatigue. The scale has been shown to have
adequate to excellent concurrent and content validity4., 5., 6., 7. and excellent test-retest reliability in patients with MS.4., 5. Rasch analysis revealed that the 21-item scale was found to contain a physical and
cognitive dimension (the original 2 social items were found to be part of the physical
dimension).4., 5. Additionally, the MFIS has been found to show change after a 4-week intervention.4., 5. The MFIS can be administered and scored in 5 to 10 minutes, making it a clinically
useful and low-burden instrument. The MFIS is free to use, and has been recommended
by the Neurology Section of the American Physical Therapy Association's Multiple Sclerosis
Taskforce.
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Publication history
Published online: September 20, 2017