Comparing Self-Report Fatigue Assessment Tools for Adults with Cerebral Palsy in a Danish Context

Figures & data

Figure 1. Participant characteristics. GMFCS = Gross Motor Function Classification System; CFCS = Communication Function Classification System.

Table 1. Statistics on composite scores.

Scale	Items	N	Mean (SD)	Skew	Median (IQR)	Floor %	Ceiling %	Cronbach’s α [95% CI]
FISSA Total	31	30	95.13 (28.58)	−0.39	102.00 (37.75)	0.00	0.00	.94 [.89, .97]
FISSA Imp.	17	30	49.10 (16.89)	0.05	49.50 (21.25)	3.33	0.00	.93 [.86, .96]
FISSA Man.	14	30	46.03 (13.24)	−0.75	50.50 (15.75)	0.00	0.00	.86 [.73, .92]
m-MFS	14	30	12.00 (6.18)	0.14	12.75 (8.25)	0.00	0.00	.86 [.77, .90]
MFI-20 GF	4	30	11.87 (3.67)	−0.40	13.00 (4.75)	6.67	0.00	.74 [.43, .87]
MFI-20 PF	4	30	11.10 (3.62)	−0.29	11.00 (5.00)	10.00	0.00	.62 [.24, .79]
MFI-20 RA	4	30	8.93 (4.04)	0.43	8.50 (6.75)	23.33	0.00	.72 [.44, .86]
MFI-20 RM	4	30	6.77 (2.36)	0.45	6.00 (4.00)	23.33	0.00	.20 [−.36, .55]
MFI-20 MF	4	30	10.30 (4.43)	−0.12	11.00 (7.75)	16.67	0.00	.82 [.68, .90]

FISSA = Fatigue Impact and Severity Self-Assessment; Imp. = Impact Scale; Man. = Management and Activity Modification Scale; m-MFS = Modified Mental Fatigue Scale; MFI-20 = Multidimensional Fatigue Inventory; GF = General Fatigue; PF = Physical Fatigue; RA = Reduced Activity; RM = Reduced Motivation; MF = Mental Fatigue.

Table 2. Diagnostic agreement in fatigue classification between the General Fatigue subscale of the Multidimensional Fatigue Inventory and the Modified Mental Fatigue Scale.

		MFI-20 GF
		Fatigue	No fatigue	Total
m-MFS	Fatigue	13	3	16
	No fatigue	6	8	14
Total		19	11	30

Total refers to total number of participants who scored above the clinical cutoff (Fatigue) and below cutoff (No fatigue) on each test respectively. The number of participants who were classified the same (agreement) or differently (disagreement) by the two tests are specified in the central fields of the table. MFI-20 GF = General Fatigue subscale of the Multidimensional Fatigue Inventory; m-MFS = Modified Mental Fatigue Scale.

Figure 2. Individual rank comparisons across scales. Higher rank corresponds to higher score. FISSA Impact = Impact Scale of the Fatigue Impact and Severity Self-Assessment; m-MFS = Modified Mental Fatigue Scale; MFI-20 = Multidimensional Fatigue Inventory. Participants are color graded according to their FISSA rank as a reference.

Table 3. Correlations among fatigue scales.

	FISSA			m-MFS	MFI-20
	1.	2.	3.	4.	5.	6.	7.	8.	9.
1. FISSA Total	1.00
2. FISSA Imp.	.97	1.00
3. FISSA Man.	.85	.76	1.00
4. m-MFS Total	.73	.75	.59	1.00
5. MFI-20 GF	.57	.58	.56	.61	1.00
6. MFI-20 PF	.35	.33	.54	.26	.42	1.00
7. MFI-20 RA	.45	.41	.45	.47	.23	.49	1.00
8. MFI-20 RM	.44	.43	.35	.45	.41	.00	.37	1.00
9. MFI-20 MF	.47	.50	.29	.59	.58	.05	.16	.63	1.00

Method = Spearman’s rank-order coefficient (ρ). FISSA = Fatigue Impact and Severity Self-Assessment; Imp. = Impact Scale; Man. = Management and Activity Modification Scale; m-MFS = Modified Mental Fatigue Scale; MFI-20 = Multidimensional Fatigue Inventory; GF = General Fatigue; PF = Physical Fatigue; RA = Reduced Activity; RM = Reduced Motivation; MF = Mental Fatigue.

Figure 3. Associations between fatigue vs. gender, age, and motor function. FISSA Impact = Impact Scale of the Fatigue Impact and Severity Self-Assessment; m-MFS = Modified Mental Fatigue Scale; MFI-20 GF = General Fatigue subscale of the Multidimensional Fatigue Inventory; GMFCS = General Motor Function Classification System. Highest and lowest possible scale score in brackets. Boxes extend to the first and third quartile, and the center line corresponds to the median. Whiskers extend to the largest and smallest value within 1.5 times the interquartile range. Dots represent individual values. Solid lines represent locally estimated scatterplot smoothing.

Data availability statement

The data for this paper cannot be made publicly available due to GDPR regulations as the combined background data at an individual level is considered personally attributable.