Fatigue and Its Association with Upper Limb Function in People with Multiple Sclerosis.

Area of Science:

• Neurology
• Rehabilitation Medicine
• Clinical Psychology

Background:

• Fatigue is a prevalent and debilitating symptom in Multiple Sclerosis (MS).
• The relationship between fatigue and upper limb (UL) function in people with MS (PwMS) requires further investigation.
• Understanding this association is critical for effective patient management and rehabilitation.

Purpose of the Study:

• To investigate the association between fatigue severity and UL function in PwMS.
• To explore the relationship between different aspects of fatigue (physical, cognitive) and UL impairments.
• To determine the impact of fatigue on both subjective and objective measures of hand and arm function.

Main Methods:

• Cross-sectional study involving 261 adult PwMS from five Italian MS centers.
• Fatigue assessed using the Modified Fatigue Impact Scale (MFIS).
• UL function evaluated via the Box and Block Test (BBT), Nine-Hole Peg Test (9HPT), and Hand-Grip Strength (HGS).

Main Results:

• Significant correlations found between fatigue severity, UL function, and patient-reported manual ability.
• Physical and cognitive fatigue components were independently associated with functional impairments.
• PwMS with clinically relevant fatigue exhibited lower subjective UL function, poorer performance on BBT and HGS, and increased HGS asymmetry.

Conclusions:

• Fatigue in PwMS is demonstrably linked to both subjective and objective measures of UL function.
• Both hand strength and dexterity are important factors contributing to the perception of fatigue.
• Integrating assessment of strength and dexterity alongside fatigue evaluation can enhance clinical understanding and inform targeted rehabilitation strategies for PwMS.