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Article type: Research Article
Authors: Dunaway Young, Sallya; b; * | Montes, Jacquelinea; c | Kramer, Samantha S.a | Podwika, Bernadettec | Rao, Ashwini K.c | De Vivo, Darryl C.a
Affiliations: [a] Department of Neurology, Columbia University Medical Center, New York, NY, USA | [b] Department of Rehabilitation and Regenerative Medicine, Columbia University Medical Center, New York, NY, USA | [c] Department of Rehabilitation & Regenerative Medicine, Program in Physical Therapy, Columbia University, New York, NY
Correspondence: [*] Correspondence to: Sally Dunaway Young, PT, DPT 180 Fort Washington Ave, 5th Floor New York, NY 10032, USA. Tel.: +1 212 304 5207; E-mail: sdy@stanford.edu.
Abstract: Background:Fatigue is a common complaint in spinal muscular atrophy (SMA). Fatigability is well described in ambulatory SMA but the relationship to perceived fatigue has not been evaluated. Understanding this relationship has proven challenging for most disorders. Objective:To assess the relationship of perceived fatigue to fatigability, function, and quality of life in SMA. Methods:Thirty-two participants with SMA (21.9% type 2, 78.1% type 3) were recruited. Perceived fatigue and fatigability, function, and quality of life were assessed using standardized questionnaires and assessments. Associations were analyzed using Pearson correlation coefficients (p = 0.05). Also, the effects of age, type, and ambulatory status were determined on perceived fatigue. Results:All SMA participants reported fatigue. Perceived fatigue was not associated with function, quality of life, or fatigability in ambulatory SMA patients. Neither age, type, nor ambulatory status influenced perceived fatigue. Conclusions:Perceived fatigue can be quantified in SMA. Interestingly, perceived fatigue did not correlate with fatigability or function, suggesting that cognitive, homeostatic, or psychologic factors may be more relevant as co-morbid factors. Clinical trials targeting perceived fatigue in SMA should focus on these patient-reported assessments. A multilevel approach is required to separate the various mechanisms involved in perceived fatigue.
Keywords: Spinal muscular atrophy, perceived fatigue, patient reported outcome measure, fatigability, clinical trials, fatigue
DOI: 10.3233/JND-180342
Journal: Journal of Neuromuscular Diseases, vol. 6, no. 1, pp. 109-117, 2019
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