Is the impact of fatigue related to walking capacity and perceived ability in persons with multiple sclerosis? A multicenter study

U. Dalgas, M. Langeskov-Christensen, A. Skjerbæk, E. Jensen, I. Baert, A. Romberg, C. Santoyo Medina, B. Gebara, B. Maertens de Noordhout, K. Knuts, F. Béthoux, K. Rasova, D. Severijns, B. M. Bibby, A. Kalron, B. Norman, F. Van Geel, I. Wens, P. Feys

Research output: Contribution to journalArticlepeer-review


Background: The relationship between fatigue impact and walking capacity and perceived ability in patients with multiple sclerosis (MS) is inconclusive in the existing literature. A better understanding might guide new treatment avenues for fatigue and/or walking capacity in patients with MS. Objective: To investigate the relationship between the subjective impact of fatigue and objective walking capacity as well as subjective walking ability in MS patients. Methods: A cross-sectional multicenter study design was applied. Ambulatory MS patients (n = 189, age: 47.6 ± 10.5 years; gender: 115/74 women/men; Expanded Disability Status Scale (EDSS): 4.1 ± 1.8 [range: 0–6.5]) were tested at 11 sites. Objective tests of walking capacity included short walking tests (Timed 25-Foot Walk (T25FW), 10-Metre Walk Test (10mWT) at usual and fastest speed and the timed up and go (TUG)), and long walking tests (2- and 6-Minute Walk Tests (MWT). Subjective walking ability was tested applying the Multiple Sclerosis Walking Scale-12 (MSWS-12). Fatigue impact was measured by the self-reported modified fatigue impact scale (MFIS) consisting of a total score (MFIS total ) and three subscales (MFIS physical , MFIS cognitive and MFIS psychosocial ). Uni- and multivariate regression analysis were performed to evaluate the relation between walking and fatigue impact. Results: MFIS total was negatively related with long (6MWT, r = −0.14, p = 0.05) and short composite (TUG, r = −0.22, p = 0.003) walking measures. MFIS physical showed a significant albeit weak relationship to walking speed in all walking capacity tests (r = −0.22 to −0.33, p <.0001), which persisted in the multivariate linear regression analysis. Subjective walking ability (MSWS-12) was related to MFIS total (r = 0.49, p < 0.0001), as well as to all other subscales of MFIS (r = 0.24–0.63, p < 0.001), showing stronger relationships than objective measures of walking. Conclusions: The physical impact of fatigue is weakly related to objective walking capacity, while general, physical, cognitive and psychosocial fatigue impact are weakly to moderately related to subjective walking ability, when analysed in a large heterogeneous sample of MS patients.

Original languageEnglish
Pages (from-to)179-186
Number of pages8
JournalJournal of the Neurological Sciences
StatePublished - 15 Apr 2018


  • Fatigue
  • Multiple sclerosis
  • Walking capacity

All Science Journal Classification (ASJC) codes

  • Neurology
  • Clinical Neurology


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