Fatigue in multiple sclerosis patients during inpatient rehabilitation

Purpose. This study was designed to evaluate symptomatic fatigue in patients with mild to moderate multiple sclerosis (MS) during inpatient rehabilitation. We examined fatigue at the beginning and at the end of a 3-week rehabilitation period as well as its daily variation. Method. Ninety-one patients participated. Fatigue severity was measured using the Fatigue Severity Scale (FSS). On the basis of the FSS scores, patients were divided into a fatigue (n=66) and non-fatigue (n=25) group. General fatigue was self-evaluated using a Visual Analogue Scale (FVAS). Depression was measured using The Centre for Epidemiologic Studies Depression scale (CES-D). Results. In the fatigue group the mean FSS score decreased by 0.34 points, whereas in the non-fatigue group it increased by 0.23 points. The difference for change between groups was significant (p=0.003), but a covariate analysis showed that this was strongly affected by a decrease in depression. Fatigue varied greatly from day-to-day. The lowest FVAS coefficient of variation per patient was 9% and the highest 131%. Conclusion. Inpatient rehabilitation decreases MS patients' fatigue. This effect seems to be modified by an improvement in mood.