Three distinct physical behavior types in fatigued patients with multiple sclerosis.

Area of Science:

• Neurology
• Rehabilitation Science
• Behavioral Science

Background:

• Multiple sclerosis (MS) frequently causes fatigue, impacting physical behavior (PB).
• Current interventions targeting MS fatigue by improving PB are insufficient.
• Understanding PB variability in fatigued MS patients is crucial for personalized rehabilitation.

Purpose of the Study:

• To identify distinct physical behavior (PB) subtypes in patients with multiple sclerosis (MS) experiencing severe fatigue.
• To utilize multidimensional PB outcome measures for subtype identification.
• To lay the groundwork for developing tailored rehabilitation programs for MS-related fatigue.

Main Methods:

• Secondary analysis of accelerometer (Actigraph) data from 212 ambulatory MS patients with severe fatigue (CIS20r score ≥35).
• Utilized 15 PB measures derived from 7-day accelerometer recordings.
• Employed principal component analysis and two-step cluster analysis to define PB measures and identify subtypes.

Main Results:

• Five key PB outcome measures were identified: sedentary behavior percentage, moderate-to-vigorous physical activity duration, sedentary bout frequency, and diurnal activity change scores.
• Three distinct and homogeneous physical behavior (PB) clusters were derived from these measures.
• These clusters represent unique patterns of physical activity in fatigued MS patients.

Conclusions:

• Patients with severe MS-related fatigue exhibit three identifiable and homogeneous PB subtypes.
• These subtypes, defined by specific PB measures, offer a novel approach for personalized rehabilitation.
• This classification can lead to more effective, individually-tailored interventions for MS fatigue.