MSQoL-54 predicts change in fatigue after inpatient rehabilitation for people with multiple sclerosis

Abstract

Purpose: The aim of our study was to investigate the impact of a short-term inpatient rehabilitation program on fatigue in patients with multiple sclerosis (MS) and to assess whether the scales of Multiple Sclerosis Quality of Life 54 (MSQoL-54) could predict change in fatigue after rehabilitation. Method: Included in the study were 151 moderately disabled MS patients admitted for 3 weeks of inpatient rehabilitation. Fatigue (Fatigue Severity Scale; FSS) was assessed at baseline and after treatment, and quality of life (MSQoL-54), disability (Expanded Disability Status Scale; EDSS) and depression (Beck Depression Inventory; BDI) were estimated at baseline. Results: Sixty-four percentage of the subjects showed fatigue. Both EDSS (r = 0.720, p = 0.001) and BDI (r = 0.655, p = 0.001) scores showed statistically significant positive correlation with FSS scores. Significant negative correlation was demonstrated between FSS and both, Physical Health Composite (PHC) and Mental Health Composite (MHC) scores of MSQoL-54 (r = −0.770, p = 0.001, and r = −0.646, p = 0.001, respectively). The mean FSS score significantly decreased by 0.19 ± 0.29 points in the fatigue group, immediately after rehabilitation. The multiple regression analyses with change of FSS as dependent variable and baseline scores of MSQoL-54 as independent variables showed statistically significant relation between change in fatigue and baseline PHC score (p = 0.034). Conclusions: Inpatient rehabilitation decreased MS patients’ fatigue. Change in fatigue was predicted with certain domains of QoL at baseline.

Implications for Rehabilitation

• The rehabilitation programmes which comprise physiotherapy (physical input) and verbal interactions with people with multiple sclerosis (MS) (non-physical input) improve fatigue in this study.

• Predictive value of certain quality of life domains on change in fatigue status could suggest that the way in which people interpret their symptoms, may have a significant impact on the effect of rehabilitation interventions for fatigue in MS.

• The assessment of the baseline quality of life may be useful in decision-making before undergoing rehabilitation therapy and could help in the process of guiding individualized rehabilitation programmes in this cohort.

Keywords::

• Fatigue
• inpatient rehabilitation
• MSQoL-54
• multiple sclerosis
• prediction
• quality of life

Declaration of Interest: This study was supported by projects of the Ministry of Education and Science of the Republic of Serbia (grants no. 175031 and 175087). There is no conflict of interest and no additional sources of funding except Jelena Drulovic.