A Head-to-Head Comparison of an Isometric and a Concentric Fatigability Protocol and the Association With Fatigue and Walking in Persons With Multiple Sclerosis

Published on May 12, 2020in Neurorehabilitation and Neural Repair3.757
· DOI :10.1177/1545968320920250
Laurits Taul-Madsen (AU: Aarhus University), Ulrik Dalgas32
Estimated H-index: 32
(AU: Aarhus University)
+ 3 AuthorsMorten Riemenschneider4
Estimated H-index: 4
(AU: Aarhus University)
: Background. Fatigue is one of the most frequent symptoms in persons with multiple sclerosis (MS). Distinction is made between subjective perceptions of fatigue and objective measures of fatigability. Fatigability can be measured by different protocols. Yet no studies have compared isometric and concentric contraction protocols of the lower extremities head-to-head. Therefore, the purpose of the present study was to (1) compare 2 such protocols head-to-head and (2) to investigate the association between fatigability evoked by the 2 protocols and measures of fatigue and walking. Methods. A total of 45 patients with MS had their walking capacity measured objectively by the 6-minute walk test (6MWT) and subjectively by the 12-item Multiple Sclerosis Walking Scale (MSWS-12). Fatigue was measured by the Modified Fatigue Impact Scale (MFIS) and fatigability by 2 knee extension protocols: sustained isometric and concentric. Results. The sustained isometric protocol induced a higher degree of fatigability than the concentric protocol (P < .01). Regression analyses revealed that sustained isometric fatigability was not associated with either measures of fatigue or walking (all r2 = 0.00; P = .85-.99), whereas the concentric protocol was significantly associated with fatigue (r2 = 0.20; P < .01), 6MWT (r2 = 0.09; P < .05), and MSWS-12 (r2 = 0.16; P < .01). Furthermore, after adjusting for maximal strength and sex, concentric fatigability remained a strong and significant predictor of fatigue (β = 0.49) and walking (6MWT: β = -0.26; MSWS: β = 0.37). Conclusion. This study provides the first evidence that a lower-extremity concentric fatigability protocol provides superior reflection of both fatigue and walking when compared with a sustained isometric protocol. We suggest that concentric protocols should be the focus of future studies investigating fatigability.
  • References (42)
  • Citations (0)
📖 Papers frequently viewed together
1 Citations
6 Citations
78% of Scinapse members use related papers. After signing in, all features are FREE.
#1Fanny Van Geel (University of Hasselt)H-Index: 3
#2Lousin Moumdjian (University of Hasselt)H-Index: 4
Last. Peter Feys (University of Hasselt)H-Index: 31
view all 5 authors...
INTRODUCTION: Fatigability, a change in performance according to tasks and circumstances, can contribute to walking limitations in daily life. Walking-related fatigability (WF) has been assessed subjectively, but current knowledge on best objective measurement methods is limited. The aim of this study was to provide an overview of objective clinical measurement methods assessing WF in different populations. EVIDENCE ACQUISITION: Articles were searched in Pubmed and Web Of Science by two independ...
2 CitationsSource
#1Fanny Van Geel (University of Hasselt)H-Index: 3
#2Renee Veldkamp (University of Hasselt)H-Index: 2
Last. Peter Feys (University of Hasselt)H-Index: 31
view all 5 authors...
Background:Day-to-day reliability and cut-off values to detect abnormal walking fatigability (WF) remain to be investigated in persons with multiple sclerosis (pwMS).Methods:In all, 49 pwMS (mean E...
3 CitationsSource
#1S. HameauH-Index: 6
#2Djamel BensmailH-Index: 9
Last. Raphael ZoryH-Index: 13
view all 4 authors...
OBJECTIVE: Fatigue and fatigability are common problems in patients with multiple sclerosis, which might be improved by rehabilitation. The aim of this pilot study was to assess changes in the fatigue and fatigability of knee extensors in patients with multiple sclerosis after a short intensive, combined rehabilitation programme (including physiotherapy primarily focused on gait and balance, endurance and resistance training). METHODS: Twenty-three patients with multiple sclerosis (10 men, 13 wo...
2 CitationsSource
#1Deborah Severijns (University of Hasselt)H-Index: 7
#2Fanny Van Geel (University of Hasselt)H-Index: 3
Last. Peter Feys (University of Hasselt)H-Index: 31
view all 3 authors...
Abstract Background Motor fatigability is increasingly acknowledged in persons with MS (pwMS). It is unknown whether fatigability is generalized across upper limb muscles and relates to fatigue and perceived difficulties in upper limb use. Methods This observational case-controlled study included twenty PwMS (median EDSS = 3, range 1.5–6.5) and twenty healthy controls who performed 30″ sustained maximal muscle contractions for index finger abduction, hand grip, elbow flexion and shoulder abducti...
2 CitationsSource
#1Daniel Langeskov-Christensen (AU: Aarhus University)H-Index: 3
#2Peter Feys (University of Hasselt)H-Index: 31
Last. Ulrik Dalgas (AU: Aarhus University)H-Index: 32
view all 6 authors...
Abstract Background The severity of walking impairment in persons with multiple sclerosis (pwMS) at different levels on the expanded disability status scale (EDSS) is unclear. Furthermore, it is unclear if the EDSS is differently related to performed- and perceived walking capacity tests. Aims To quantify walking impairment and perceived impact of MS on walking according to EDSS scores and to examine the relations between these parameters in pwMS. Methods EDSS was collected by neurologists and w...
13 CitationsSource
#1Rivka GreenH-Index: 4
#2Gary R CutterH-Index: 2
Last. Ilya KisterH-Index: 19
view all 4 authors...
BackgroundMultiple sclerosis is a polysymptomatic disease. Little is known about relative contributions of the different multiple sclerosis symptoms to self-perception of health.ObjectivesTo investigate the relationship between symptom severity in 11 domains affected by multiple sclerosis and self-rated health.MethodsMultiple sclerosis patients in two multiple sclerosis centers assessed self-rated health with a validated instrument and symptom burden with symptoMScreen, a validated battery of Li...
5 CitationsSource
#1Bryan D. Loy (OHSU: Oregon Health & Science University)H-Index: 6
#2Ruby L. Taylor (Santa Clara University)H-Index: 1
Last. Fay B. Horak (OHSU: Oregon Health & Science University)H-Index: 84
view all 4 authors...
Abstract Background Perceived fatigue (i.e., subjective perception of reduced capacity) is one of the most common and disabling symptoms for people with multiple sclerosis (MS). Perceived fatigue may also be related to performance fatigability (i.e., decline in physical performance over time), although study findings have been inconsistent. Objective To locate all studies reporting the relationship between perceived fatigue and fatigability in people with MS, determine the population correlation...
11 CitationsSource
#1Simeon P. Cairns (AUT: Auckland University of Technology)H-Index: 14
#2Luke A. G. Inman (USYD: University of Sydney)H-Index: 1
Last. Martin W. Thompson (USYD: University of Sydney)H-Index: 27
view all 7 authors...
Purpose To determine the roles of calcium (Ca2+) handling by sarcoplasmic reticulum (SR) and central activation impairment (i.e., central fatigue) during fatigue with repeated maximal voluntary isometric contractions (MVC) in human muscles.
2 CitationsSource
#1M.L.K. Jørgensen (AU: Aarhus University)H-Index: 3
#2Ulrik Dalgas (AU: Aarhus University)H-Index: 32
Last. Lars G. Hvid (AU: Aarhus University)H-Index: 15
view all 4 authors...
Abstract Background Multiple sclerosis (MS) is a chronic disease in the central nervous system which causes a number of physical symptoms including impairments of muscle mechanical function (muscle strength, muscle power and explosive muscle strength (~ rate of force development, RFD)). However, a full overview of the existing knowledge regarding muscle mechanical function in persons with MS (PwMS) is still pending. Objectives To systematically review 1) the psychometric properties of isokinetic...
12 CitationsSource
#1Frederick M. Ivey (UMB: University of Maryland, Baltimore)H-Index: 24
#2Steven J. Prior (UMB: University of Maryland, Baltimore)H-Index: 14
Last. Alice S. Ryan (UMB: University of Maryland, Baltimore)H-Index: 48
view all 6 authors...
Background and Purpose Initial studies support the use of strength training (ST) as a safe and effective intervention after stroke. Our previous work shows that relatively aggressive, higher intensity ST translates into large effect sizes for paretic and non-paretic leg muscle volume, myostatin expression, and maximum strength post-stroke. An unanswered question pertains to how our unique ST model for stroke impacts skeletal muscle endurance (SME). Thus, we now report on ST-induced adaptation in...
6 CitationsSource
Cited By0