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Fatigue is a common symptom in patients with various chronic diseases, especially multiple sclerosis (MS). Studies using questionnaires found fatigue a major problem in approximately 75 to 87% of the patients. [1-3] However, there are no generally accepted medical criteria to define fatigue or to distinguish it from other symptoms, such as depression or weakness. Studies on the mechanism of fatigue have not yielded agreement as to whether fatigue in MS is of peripheral or central origin. [4-7]
The aim of the present study was to quantitatively characterize fatigue in MS using a novel computerized strategy. We constructed a device to quantitatively measure maximal muscle strength and analyze the strength/time curve of isometric muscle contraction. We propose the use of a fatigue index (FI) based on the ratio between muscle endurance and maximal voluntary contractions (MVC), in contrast to other studies that measured the ratio between postexercise MVC and initial MVC. The advantage of our technique is the isolation of the fatigue element and the consequent exclusion of weakness of muscles examined. Moreover, the results are analyzed on-line. Using the system, we studied the possible differences in FI among subtypes of MS patients and the correlation, if present, with neurologic disability, and duration and exacerbations of disease.
Methods.
Patients.
Thirty patients with MS (20 women, 10 men) of mean age 37.4 plus minus 10.3 years (range, 18 to 59 years) were included in the study. All had a definite diagnosis of MS based on the criteria of Poser et al. [8] Only patients with an Expanded Disability Status Scale (EDSS) score from 1.0 to 6.5 (mean plus minus SD, 3.3 plus minus 2.5) who exhibited only mild to moderate symptoms of MS and could perform the motor tasks were enrolled. We evaluated patients using the Fatigue Severity Scale of Krupp et al. …
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