Effect of Mind Sound Resonance Technique (MSRT) on Fatigue level among Type 2 Diabetics

Background: Fatigue represents a common complaint of patients with diabetes as it can be reported in up to 60% of patients, prominent in patients with type 2 diabetes. It is a major health problem, affects approximately 6% of the world's adult population, and is increasing in epidemic proportions. Evidence suggests that MSRT a yoga-based relaxation techniques significantly reduces anxiety, stress, fatigue and psychological distress. The aim of the study wasObjective: to study the effect of MSRT on fatigue levels among type-2 diabetes patients. Materials and Methods: In this interventional study with a pre-post design on 100 type-2 diabetes patients, were taught MSRT. Assessment were carried out on the 1 and 30 day of the program, using FSS, VAFS. Results: Significant reduction in fatigue levels in both FSS and VAFS respectively (p<0.00). Conclusion: This study provides evidence that MSRT practice is an effective, economical and noninvasive method to combat fatigue in diabetes patients.

Clinical Study on Transcutaneous Acupoint Electrical Nerve Stimulation for Post-stroke Fatigue / 上海针灸杂志

Objective To observe the clinical efficacy of transcutaneous acupoint electrical nerve stimulation (TEAS) in treating post-stroke fatigue.Method A total of 80 patients with post-stroke fatigue were randomized into a treatment group and a control group, 40 cases in each group. The control group was intervened by conventional post-stroke treatment, while the treatment group by TEAS in addition to the intervention given to the control group. The treatment was given once a day, 7 d as a treatment course, successively for 2 treatment courses with 1-d interval between the two courses. The National Institutes of Health Stroke Scale (NIHSS) and Fatigue Severity Scale (FSS) were observed before and after the treatment.Result After 2 treatment courses, the NIHSS and FSS scores in the treatment group were significantly different from those before the treatment (P<0.05). The NIHSS and FSS scores in the treatment group were significantly different from those in the control group after 2 treatment courses (P<0.05). Conclusion TEAS can effectively alleviate the symptoms of post-stroke fatigue and promote the recovery.

Phototest for neurocognitive screening in multiple sclerosis / O Fototest no rastreio neurocognitivo na Esclerose Múltipla

Multiple Sclerosis (MS) is one of the most common neurological disorders. Cognitive dysfunction is considered a clinical marker of MS, where approximately half of patients with MS have cognitive impairment. Objective : The Phototest (PT) is a brief cognitive test with high diagnostic sensitivity, accuracy and cost-effectiveness for detecting cognitive deterioration. Our aim was to test the utility of the PT as a neurocognitive screening instrument for MS. Methods : The study enrolled 30 patients with different types of MS from an outpatient clinic as well as 19 healthy participants. In conjunction with the PT, the Montreal Cognitive Assessment (MoCA), Barthel Index (BI), Expanded Disability Status Scale (EDSS), and Fatigue Severity Scale (FSS) were administered. Results : The MS group obtained significantly lower results on all domains of the PT, except for the naming task. The PT showed good concurrent validity with the MoCA. In direct comparison to the MoCA, PT showed a greater area under the curve and higher levels of sensitivity and specificity for MS neurocognitive impairments. A cut-off score of 31 on the Phototest was associated with sensitivity of 100% and specificity of 76.7%. Conclusion : The PT is a valid, specific, sensitive and brief test that is not dependent on motor functions. The instrument could be an option for neurocognitive screening in MS, especially in identifying cases for further neuropsychological assessment and intervention.

A Esclerose Múltipla (EM) é das doenças neurológicas mais comuns. A disfunção cognitiva consiste num marcador clínico da EM, cerca de metade dos pacientes apresentam comprometimento cognitivo. Objetivo : O Fototest (FT) é um teste breve, sensível, específico e com boa relação custo-eficácia na deteção de deterioração cognitiva. Pretendemos testar a validade do FT como um instrumento de screening neurocognitivo na EM. Métodos : O estudo envolveu uma amostra de 30 doentes com diferentes tipos de EM de uma clínica de tratamento ambulatório e 19 participantes saudáveis. Em conjunto com o FT, foram aplicados o Montreal Cognitive Assessment (MoCA), o Índice de Barthel (IB), a Expanded Disability Status Scale (EDSS) e a Escala de Severidade de Fadiga (FSS). Resultados : O grupo EM obteve resultados significativamente inferiores em todos os domínios do FT, excepto na tarefa de nomeação. O FT apresenta boa validade concorrente com o MoCa. Na comparação direta com o MoCa, o FT revelou uma área sob a curva superior e níveis de sensibilidade e especificidade para os défices cognitivos na EM superiores. Ao ponto de corte de 31 no FT correspondem valores de sensibilidade de 100% e especificidade de 76,7%. Conclusão : O FT é um teste válido, específico, sensível e breve, não dependente das funções motoras. Pode ser uma opção para o screening neurocognitivo na EM, especialmente na identificação de casos para posterior avaliação neuropsicológica e intervenção.

Correlation between aerobic capacity and fatigue in subjects with post- polio syndrome.

Introduction: Post-polio syndrome (PPS) is defined by Halstead and Ross as having a period of at least 15 years of neurologic and functional stability followed by onset of two or more of the following new health problems: unexplained fatigue, muscle or joint pain, muscle weakness, and cold intolerance and exclusion of other medical diagnosis. Fatigue occurs in 59-89% of PPS patients.Aerobic capacity during functional activities may also decrease in subjects with PPS which may lead to fatigue or vice versa. This study aimed to correlate the aerobic capacity using the 2 minute walk distance (2MWD) with fatigue using Fatigue Severity Scale (FSS) in subjects with PPS. Material and methods: An observational study using convenience sampling was conducted in a community setting, in Surat on 19 individuals with PPS. Inclusion criteria were according to the old Halstead criteria and individuals who were able to walk with and without walking aids. Individuals who were on psychotropic medications, a diagnosed respiratory or cardiac condition, who were uncooperative due to cognitive impairment and those who were unwilling to participate were excluded. Outcome measures were Two Minute Walk distance (2MWD) for aerobic capacity and Fatigue Severity Scale (FSS) for fatigue. The subjects were asked to fill a questionnaire which included their demographic data and the Fatigue Severity Scale. They were asked to walk on a25 m long corridor as far as they could, for 2 minutes. They were explained that if they felt breathless or fatigued, then they could stop. At the completion of 2 minutes, distance was recorded. Results: The mean 2MWD was 76.02±1.37 m and FSS was 40.25±3.50. The value of Spearman’s correlation coefficient was -0.46 (p=0.48).The study shows moderate correlation between FSS and 2MWD which was statistically significant. Conclusion: Fatigue influences the aerobic capacity of subjects with post- polio syndrome and vice versa.

Reliability and Validity of the Fatigue Severity Scale among University Student in South Korea

OBJECTIVES: There are only a limited number of studies on instruments assessing fatigue in university students, although fatigue exerts negative influences on their health and academic performances and fatigue-related complaints are more frequently reported in young adults than middle-aged adults. The aim of this study was to validate the 9-item Fatigue Severity Scale (FSS) among university students including both undergraduate and graduate students in South Korea. METHODS: A total of 176 university students completed a battery of self-report questionnaires, including the FSS, the Brief Fatigue Inventory (BFI), the Beck Depression Inventory-II (BDI-II), the Beck Anxiety Inventory (BAI), the Medical Outcomes Study Short Form 36 version 2 (MOS-SF36v2), and the Inclusion of Community in the Self Scale (ICS). The data were collected from February of 2012 to June of 2012. The reliability, convergent validity, divergent validity, and exploratory factor analyses were conducted to assess psychometric properties of the FSS. RESULTS: The mean FSS score was 3.20 (standard deviation = 1.43). The FSS demonstrated an excellent internal consistency (Cronbach's alpha = 0.93) and item-total correlations ranged from 0.56 to 0.90. Correlations of the FSS with the BFI (r = 0.71, p < 0.01), BDI-II (r = 0.54, p < 0.01), BAI (r = 0.46, p < 0.01), MOS-SF36v2 physical component summary (r = -0.28, p < 0.01), MOS-SF36v2 mental component summary (r = -0.55, p < 0.01), and ICS (Spearman's rho = -0.07, p = 0.33) showed acceptable convergent and divergent validity. Exploratory factor analysis defined one underlying factor (eigenvalue = 5.67) that explained 93.50% of the total variance. CONCLUSIONS: To the best of our knowledge, this is the first study to investigate reliability and validity of the FSS in university students. The FSS exhibits good psychometric properties for evaluation of fatigue among university students in South Korea. Since the FSS is easy to administer, score, and interpret, it could be a useful tool in research and practice for assessing fatigue among university students.

Reliability and validity study of a Brazilian-Portuguese version of the fatigue severity scale in Parkinson's disease patients / Validação e reprodutibilidade da versão brasileira da escala de gravidade de fadiga em pacientes com doença de Parkinson

The Fatigue Severity Scale (FSS) is one of the most frequently used self-rating scales for fatigue in Parkinson's disease (PD) and it lacks a validated Brazilian-Portuguese version. OBJECTIVE: To determine the construct validity and reproducibility of a Brazilian-Portuguese version of the FSS in patients with PD. METHODS: In a cross-sectional study, a Portuguese-language version of the FSS was applied to 30 patients with PD (62±11 years-old). The Parkinson's disease questionnaire (PDQ-39) was used as the validation criterion, while the Hoehn and Yahr scale, the Unified Parkinson's Disease Rating Scale (UPDRS), and the Beck Depression Inventory were employed to analyze the correlations with the FSS score. RESULTS: The test-retest intraclass correlation coefficient was 0.91 (p<0.01) for the Brazilian-Portuguese version of the FSS score, which was highly correlated with the PDQ-39 overall score (r=0.93; p<0.01) and the Beck Depression Inventory (r=0.75; p<0.01). It showed a correlation with the Hoehn and Yahr scale (r=0.40; p=0.02), and with the UPDRS as well (r=0.45, p=0.01). CONCLUSIONS: The Brazilian-Portuguese version of the FSS is valid and reproducible for using in Brazilian patients with PD.

A Fatigue Severity Scale (FSS-BR) é uma das mais usadas para avaliação da fadiga na doença de Parkinson e até hoje não foi validada para o português no Brasil. OBJETIVO: Determinar a validade de construto e a reprodutibilidade da versão brasileira da (FSS-BR) em pacientes com doença de Parkinson. MÉTODOS: Em um estudo de corte transversal, a versão brasileira da Fatigue Severity Scale foi aplicada em 30 pacientes com doença de Parkinson (62±11 anos). O questionário de qualidade de vida da doença de Parkinson (PDQ-39) foi utilizado como critério de validação, assim como a escala Hoehn e Yahr (HY), a Escala de Graduação Unificada da Doença de Parkinson (UPDRS) e o Inventário de Depressão de Beck (BDI) foram empregados para analisar as correlações com a FSS-BR. RESULTADOS: O coeficiente de correlação intraclasse foi 0,91 (p<0,01) para a versão brasileira do escore da FSS, que foi muito correlacionado com o escore total do PDQ-39 (r=0,93; p<0,01) e com o BDI (r=0,75; p<0,01); demonstrou também correlação com a escala de gravidade HY (r=0,40; p=0,02), e com a escala UPDRS (r=0,45, p=0,01). CONCLUSÕES: A FSS-BR mostrou-se válida e reprodutível para uso em pacientes brasileiros com doença de Parkinson.

Astenia en pacientes que asisten a la consulta externa: valoración a través de la escala de intensidad de fatiga (FSS) / Asthenia in patients attending the outpatient clinic: valuation through the rating scale fatigue

Muchos pacientes acuden a consulta externa con un conjunto inespecífico de síntomas y signos que sugieren el diagnóstico de astenia, sin encontrarse una causa orgánica que explique dichos síntomas. Se realizó un estudio prospectivo a nivel nacional para diagnosticar y cuantificar la intensidad de la astenia en estos pacientes y medir la eficacia de la sulbutiamina 400 mg/día como tratamiento farmacológicoa corto plazo de primera línea. Se realizó un estudio abierto, prospectivo y multicéntrico,en el cual se ingresaron 341 pacientes, que consultaron ambulatoriamente y que presentaban síntomas de astenia. A través de la escala de Intensidad de Fatiga (por sus siglas en inglés: Fatigue Severity Scale - FSS) se determinó la presencia de astenia en estos pacientes y se evaluó la eficacia de la sulbutiamina 400 mg/día de Laboratorios Leti S.A.V., Venezuela (Tekron®). El estudio tuvo una duración de 15 días, en los cuales el paciente fue evaluado tres veces: día 1 (inicio), día 7 y día 15. Si el paciente presentaba astenia (puntuación ≥ 36 puntos en la FSS), se le indicaba sulbutiamina400 mg/día con el desayuno por 15 días. El 74,7% de los pacientes evaluados fueron del sexo femenino, con una edad media de 43,7 ± 12,5 años y el 25,3% del sexo masculino con una edad media de 41,7 ± 13,5 años. Al inicio del estudio la media de la puntuación de la FSS fue de 49,7 ± 7,3 puntos; a los 7 días de tratamiento con 400 mg/día de sulbutiamina fue de 37,2 ± 8,8 puntos con una disminucióndel 25,2% y al día 15 fue de 28,0 ± 9,8 puntos con una disminución de 43,7% con respecto al inicio del tratamiento, resultando estadísticamente significativo (p< 0,0001 y p< 0,0001 al día 7 y día 15 vs inicio, respectivamente). El 77,7% de los pacientes respondieron al tratamiento al día 15. La sulbutiamina resultó ser un tratamiento muy bien tolerado, se reportaron eventos adversos leves en 132 pacientes (38,7%) al día 7 y en 115 pacientes(33,7%) al día 15...

Many patients attending out patient clinics with a set of nonspecific symptoms and signs that suggest the diagnosis asthenia, without organic cause to explain the symptoms. In order to determine which of was these patients confirmed the diagnosis of functional asthenia, was performed a prospective nation wide, study to diagnose and quantify the intensity of fatigue in these patients and measure the effectiveness of sulbutiamine 400 mg/day treatment short-term drug frontline. Was realized an open, prospective, multicenter study, which entered 341 outpatient patients which showed signs of fati gue. The Fatigue Severity Scale (FSS) was used as a tool for the diagnosis and evaluation of severity of fatigue and was evaluated the effectiveness of sulbutiamine 400 mg/day to Leti Laboratories, S.A.V. (Tekron®), as first line treatment.The duration of the study was 15 days, with 3 evaluations (day 1 or baseline, day 7 and day 15). The score of the FSS had to be ≥ 36 points to be enrolled. 74,7% of patients were females with a mean age of 43,7 ± 12,5 years old and 25,3% were males with a mean age of 41,7 ± 13,5 years old. At baseline, the FSS score was 49,7 ± 7,3 points; at day 7 was 37,2 ± 8,8 points with a decrease of 25,2% and at day 15 was 28,0 ± 9,8 points, with a decrease of 43,7% respective to baseline, being statistically significant (p< 0,0001 and p< 0,0001 at day 7 and day 15, respectively). The percentage of response to treatment was 77,7% at day 15. Sulbutiamine was a very well tolerated treatment, there were reported mild adverse events in 132 patients (38,7%) at day 7 and in 115 patients (33,7%) at day 15. Sulbutiamine 400 mg/day is a secure treatment, it is well tolerated and effective in improving the asthenia symptoms, as demonstrated in this clinical trial by the significant decrease in the FSS mean score and the percentage of patients with asthenia at day 15 of treatment

Factors Influencing on Fatigue in Patients with Epilepsy / 대한간질학회지

PURPOSE: Fatigue is defined as a tired feeling, lack of energy, or feeling of exhaustion. Antiepileptic drugs, seizure and frequent interictal epileptiform activity can cause fatigue in epilepsy patients. The aim of this study is to determine the rate of fatigue and to assess the influence of clinical and demographic factors on fatigue in patients with epilepsy. METHODS: Fatigue was evaluated in 39 epilepsy patients by using Fatigue Severity Scale (FSS). Multiple regression analysis was performed to assess the influence of different factors on fatigue. RESULTS: In patients with epilepsy the mean score of FSS was 4.54+/-1.69, and the rate of fatigue was 66.7%. Among these patients, 23.1% had medium fatigue, and 43.6% had serious fatigue. The variable that strongly predicted a high FSS mean score was high seizure frequency. Conclusion: Fatigue is very common, and seizure frequency is an important factor influencing on fatigue in epilepsy patients.

Evaluation of Chinese Version of 3 Fatigue Questionnaires for Stroke Patients / 中国康复理论与实践

@#Objective To analyze the instruments for post stroke fatigue, Fatigue Severity Scale (FSS)，Checklist Individual Strength (CIS) and Fatigue Impact Scale (FIS). Methods The FSS，CIS and FIS were applied in 214 cases with cerebral infarction. They were combined together at the (sub)scale level, and evaluated with Mokken Scale Analysis for Polytomous Items, for validity and reliability. Results and Conclusion Three scales were and The combined scale proved to be acceptable (H>0.5). 3 components were extracted in factor analysis, and the their total cumulative contribution was 77.504%, with reliability (α) of 0.8097，0.7094 and 0.8019 respectively. FSS put emphasis on the fatigue experiences of stroke patients, CIS on the influence of fatigue on, and FIS on the social function.