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09-03-2017 | Uitgave 5/2017 Open Access

Journal of Behavioral Medicine 5/2017

Tracking daily fatigue fluctuations in multiple sclerosis: ecological momentary assessment provides unique insights

Tijdschrift:
Journal of Behavioral Medicine > Uitgave 5/2017
Auteurs:
Daniel J. H. Powell, Christina Liossi, Wolff Schlotz, Rona Moss-Morris
Belangrijke opmerkingen

Electronic supplementary material

The online version of this article (doi:10.​1007/​s10865-017-9840-4) contains supplementary material, which is available to authorized users.

Abstract

Studies investigating the prevalence, cause, and consequence of multiple sclerosis (MS) fatigue typically use single measures that implicitly assume symptom-stability over time, neglecting information about if, when, and why severity fluctuates. We aimed to examine the extent of moment-to-moment and day-to-day variability in fatigue in relapsing-remitting MS and healthy individuals, and identify daily life determinants of fluctuations. Over 4 weekdays, 76 participants (38 relapsing-remitting MS; 38 controls) recruited from multiple sites provided real-time self-reports six times daily (n = 1661 observations analyzed) measuring fatigue severity, stressors, mood, and physical exertion, and daily self-reports of sleep quality. Fatigue fluctuations were evident in both groups. Fatigue was highest in relapsing-remitting MS, typically peaking in late-afternoon. In controls, fatigue started lower and increased steadily until bedtime. Real-time stressors and negative mood were associated with increased fatigue, and positive mood with decreased fatigue in both groups. Increased fatigue was related to physical exertion in relapsing-remitting MS, and poorer sleep quality in controls. In relapsing-remitting MS, fatigue fluctuates substantially over time. Many daily life determinants of fluctuations are similar in relapsing-remitting MS and healthy individuals (stressors, mood) but physical exertion seems more relevant in relapsing-remitting MS and sleep quality most relevant in healthy individuals.

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Extra materiaal
Supplementary material 1 (DOCX 16 kb)
10865_2017_9840_MOESM1_ESM.docx
Supplementary material 2 (DOCX 18 kb)
10865_2017_9840_MOESM2_ESM.docx
Supplementary material 3 (DOCX 23 kb)
10865_2017_9840_MOESM3_ESM.docx
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