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Can motor fatigue be measured? - On the relation of fatigue trait, perceived exertion, and gait analysis measures after 6minute walking
ECTRIMS Online Library. Drebinger D. Oct 12, 2018; 232029
Daniel Drebinger
Daniel Drebinger
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Abstract: 276

Type: Scientific Session

Abstract Category: Clinical aspects of MS - MS symptoms

Introduction: Fatigue and walking impairment are among the most common complaints in multiple sclerosis (MS). Fatigue is conceived as a multidimensional construct related to patient's perception as well as fatigability of motor or cognitive performance. Recent fatigue questionnaires address both domains in separate subscores. Changes in gait parameters with prolonged exercise has been described in MS, the relation of such changes to the perception of exertion as well as motor fatigue remains unclear.
Objectives: To explore if motor fatigue in MS can be captured by changes in quantitative gait analysis after 6-minute walking (6MW).
Aims: To describe changes in gait parameters and perceived exertion after 6MW and their relation to perceived exertion at baseline, disability scores, self-reported walking impairment and fatigue scores in MS.
Methods: This pilot trial included 15 people with MS (pwMS) (EDSS 1-6) and 8 healthy subjects (HC). All participants rated their perception of exertion (Borg scale) before and after 6-minute walking and their walking impairment (MSWS-12) at baseline only.
Gait analysis of 15m level walks with U-turn was recorded with a 6-sensor inertial system (Mobility Lab, APDM) before and after 6MW. Subjects were instructed to walk at their preferred and fastest speed.
Results: The Fatigue Scale for Motor and Cognitive Function (FSMC) indicated fatigue in most pwMS and their ratings of perceived exertion were higher than in HC. 6MW evoked increases in perceived exertion in both, HC and pwMS. Despite this, both groups featured faster preferred speed after 6MW (trend only in pwMS), more armswing and lateral trunk movement. These changes were related to Borg baseline. At fast gait speed, pwMS featured shorter stride length and decreased speed after 6MW. This change as well as change in Borg rating with 6MW was related to EDSS, Borg baseline and MSWS-12. We did not observe associations of perceived exertion or gait changes with 6MW and FSMC (sub)scores.
Conclusions: 6MW is perceived as an exhaustive task by both, HC and pwMS. Increase of preferred speed after 6MW suggests an overflow of previous 6MW fast pace walking in both groups. Gait analysis at fast speed revealed changes in pwMS compatible with motor fatigueing. These seem to reflect change in perceived exertion after 6MW that is in turn related to MS disability and walking impairment but not to self-report of motor fatigue according to current constructs.
Disclosure: DD, LR, PA, AC have nothing to disclose.
JBS has received travel grants and speaking fees from Bayer Healthcare, Biogen Idec, Merck Serono, sanofi-aventis/Genzyme, Teva Pharmaceuticals, and Novartis.
FP serves on the scientific advisory board for Novartis; received speaker honoraria and travel funding from Bayer, Novartis, Biogen Idec, Teva, Sanofi-Aventis/Genzyme, Merck Serono, Alexion, Chugai, MedImmune, and Shire; is an academic editor for PLoS ONE; is an associate editor for Neurology® Neuroimmunology & Neuroinflammation; consulted for SanofiGenzyme, Biogen Idec, MedImmune, Shire, and Alexion; and received research support from Bayer, Novartis, Biogen Idec, Teva, Sanofi-Aventis/Genzyme, Alexion, Merck Serono, German Research Council, Werth Stiftung of the City of Cologne, German Ministry of Education and Research, Arthur Arnstein Stiftung Berlin, EU FP7 Framework Program, Arthur Arnstein Foundation Berlin, Guthy Jackson Charitable Foundation, and National Multiple Sclerosis of the USA.
AUB is cofounder and shareholder of Motognosis and Nocturne. He is named as inventor on several patent applications regarding MS serum biomarkers, OCT image analysis and perceptive visual computing.
TSH received research grants from Ipsen Pharma and speaker honoraria from Rölke pharma.

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