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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2020; 78(08): 473-480
DOI: 10.1590/0004-282X20200033
Original Article

Fatigue in Parkinson’s disease: Brazilian validation of the modified fatigue impact scale

Fadiga na doença de Parkinson: validação brasileira da escala modificada de impacto da fadiga
Josiane LOPES 
1   Universidade Estadual do Centro-Oeste, Departamento de Fisioterapia, Guarapuava PR, Brazil.
2   Universidade Estadual de Londrina, Programa de Pós-Graduação em Ciências de Reabilitação, Londrina PR, Brazil.
,
Hayslenne Andressa Gonçalves de Oliveira ARAÚJO 
2   Universidade Estadual de Londrina, Programa de Pós-Graduação em Ciências de Reabilitação, Londrina PR, Brazil.
,
Suhaila Mahmoud SMAILI 
3   Universidade Estadual de Londrina, Programa de Pós-Graduação em Ciências de Reabilitação, Departamento de Fisioterapia, Londrina PR, Brazil.
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ABSTRACT

Background: The instruments that measure the impact of fatigue on physical, cognitive and psychosocial aspects has yet to be validated in Brazilian population with Parkinson’s disease (PD). The aim of this study was to cross-culturally adapt and assess the psychometric properties of the Brazilian version of the Modified Fatigue Impact Scale (MFIS-PD/BR). Methods: Ninety PD individuals were recruited. The adaptation of the MFIS-PD was performed by translation and back translation methodology. Psychometric analysis was applied in order to perform the administration of the socio-clinical questionnaire, Mini-Mental State Examination (MMSE), Unified Parkinson’s Disease Rating Scale (UPDRS Part I-IV), Hoehn-Yahr disability scale (HY), hospital anxiety and depression scale (HADS), Geriatric Depression Scale (GDS), fatigue severity scale (FSS), Parkinson Fatigue Scale (PFS-16), and MFIS-PD/BR with retest of the MFIS-PD/BR after 7 days. Results: The adaptation phase kept the same items of original MFIS-PD. The Cronbach’s alpha for the MFIS-PD/BR was 0.878 when all responses items were scored. The test-retest intraclass correlation coefficients was above 0.80 (p<0.01) for the MFIS-PD/BR score, which was moderately correlated with the HADS, GDS, MDS-UPDRS score total and non-motor experiences of daily living, FSS and PFS-16. It was revealed the MFIS-PD/BR>29 points as cut-off point to indicate fatigued subjects with accuracy of 0.835 (p<0.001). Conclusions: The MFIS-PD/BR is valid and reproducible to use in assessing the fatigue symptom in Brazilian PD subjects.

RESUMO

Introdução: Os instrumentos que mensuram o impacto da fadiga nos aspectos físicos, cognitivos e psicossociais ainda não foram validados na população brasileira com doença de Parkinson (DP). O objetivo deste estudo foi adaptar culturalmente e avaliar as propriedades psicométricas da versão brasileira da escala modificada de impacto da fadiga (MFIS-PD/BR). Métodos: Setenta indivíduos com DP foram recrutados. A adaptação do MFIS-PD foi realizada pela metodologia de tradução e retrotradução. Na análise psicométrica foi realizada a administração de questionário socioclínico, Miniexame do estado mental (Mini-Mental State Examination - MMSE), Escala Unificada de Avaliação da DP (Unified Parkinson’s Disease Rating Scale - UPDRS Parte I-IV), escala de incapacidade Hoehn-Yahr (HY), escala hospitalar de ansiedade e depressão (Hospital Anxiety and Depression Scale - HADS), escala de depressão geriátrica (Geriatric Depression Scale - GDS), escala de gravidade da fadiga (Fatigue Severity Scale - FSS), escala de fadiga de Parkinson (Parkinson Fatigue Scale - PFS-16) e a MFIS-PD/BR com reteste após 7 dias. Resultados: A fase de adaptação manteve os mesmos itens do MFIS-PD original. O coeficiente alfa de Cronbach para o MFIS-PD/BR foi de 0,878 quando todos os itens das respostas foram pontuados. Os coeficientes de correlação intraclasse teste-reteste foram superiores a 0,80 (p<0,01) para o escore MFIS-PD/BR, que foi moderadamente correlacionado com o escore HADS, GDS, MDS-UPDRS, total e aspectos não-motores da vida diária, FSS e PFS-16. Foi revelado o ponto de corte do MFIS-PD/BR>29 pontos para indicar indivíduos fatigados com acurácia de 0,835 (p<0,001). Conclusões: O MFIS-PD/BR é válido e reprodutível para a avaliação do sintoma de fadiga em indivíduos brasileiros com DP.

Keywords:

Parkinson Disease - Fatigue - Validation Studies - Psychometrics

Palavras-chave:

Doença de Parkinson - Fadiga - Estudos de Validação - Psicometria


Publication History

Received: 08 February 2020

Accepted: 03 March 2020

Article published online:
13 June 2023

© 2020. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Kluger BM, Krupp LB, Enoka RM. Fatigue and fatigability in neurologic illnesses: proposal for a unified taxonomy. Neurology. 2013 Jan;80(4):409-16. https://doi.org/10.1212/WNL.0b013e31827f07be
  • 2 Kluger BM, Herlofson K, Chou KL, Lou JS, Goetz CG, Land AE, et al. Parkinson's disease-related fatigue: a case definition and recommendations for clinical research. Mov Disord. 2016 May;31(5):625-31. https://doi.org/10.1002/mds.26511
  • 3 Herlofson K, Kluger BM. Fatigue in Parkinson's disease. J Neurol Sci. 2017 Mar;374:38-41. https://doi.org/10.1016/j.jns.2016.12.061
  • 4 Siciliano M, Trojano K, Santangelo G, De Micco R, Tedeschi G, Tessitore A. Fatigue in Parkinson's disease: a systematic review and meta-analysis. Mov Disord. 2018 Nov;33(11):1712-23. https://doi.org/10.1002/mds.27461
  • 5 Kluger BM, Garimella S, Garvan C. Minimal clinically important difference of the Modified Fatigue Impact Scale in Parkinson's disease. Parkinsonism Relat Disord. 2017 Oct;43:101-104. https://doi.org/10.1016/j.parkreldis.2017.07.016
  • 6 Stocchi F, Abbruzzese G, Ceravolo R, Cortelli P, D'Amelio M, De Pandis MF, et al. Prevalence of fatigue in Parkinson disease and its clinical correlates. Neurology. 2014 Jul;83(3):215-20. https://doi.org/10.1212/WNL.20200033202000330587
  • 7 Friedman JH, Alves G, Hagell P, Marinus J, Marsh L, Martinez-Martin P, et al. Fatigue rating scales critique and recommendations by the Movement Disorders Society task force on rating scales for Parkinson’s disease. Mov Disord. 2010 May;25(7):805-22. https://doi.org/10.1002/mds.22989
  • 8 Spirgi S, Meyer A, Calabrese P, Gschwandtner U, Fuhr P. Effects of cognitive performance and affective status on fatigue in Parkinson’s disease. Dement Geriatr Cogn Disord Extra. 2019;9(3):344-51. https://doi.org/10.1159/000498883
  • 9 Schiehser DM, Ayers CR, Liu L, Lessig S, Song DS, Filoteo JV. Validation of the Modified Fatigue Impact Scale in Parkinson’s disease. Parkinsonism Relat Disord. 2013 Mar;19(3):335-8. https://doi.org/10.1016/j.parkreldis.2012.11.013
  • 10 Krupp LB, LaRocca NG, Muir-Nash J, Steinberg AD. The fatigue severity scale. Application to patients with multiple sclerosis and systemic lupus erythematosus. Arch Neurol. 1989 Oct;46(10):1121-3. https://doi.org/10.1001/archneur.1989.00520460115022
  • 11 Brown RG, Dittner A, Findley L, Wessely SC. The Parkinson fatigue scale. Parkinsonism Relat Disord. 2005 Jan;11(1):49-55. https://doi.org/10.1016/j.parkreldis.2004.07.007
  • 12 Smets EM, Garssen B, Bonke B, De Haes JC. The Multidimensional Fatigue Inventory (MFI) psychometric qualities of an instrument to assess fatigue. J Psychosom Res. 1995 Apr;39(3):315-25. https://doi.org/10.1016/0022-3999(94)00125-o
  • 13 Fisk JD, Ritvo PG, Ross L, Haase DA, Marrie TJ, Schlech WF. Measuring the functional impact of fatigue: initial validation of the fatigue impact scale. Clin Infect Dis. 1994 Jan;18 Suppl 1:S79-83. https://doi.org/10.1093/clinids/18.supplement_1.s79
  • 14 Multiple Sclerosis Council for Clinical Practice Guidelines. Fatigue and multiple sclerosis: evidence-based management strategies for fatigue in multiple sclerosis. Washington, D.C.: Paralyzed Veterans of America, 1998.
  • 15 Valderramas S, Feres AC, Melo A. Reliability and validity study of a Brazilian-Portuguese version of the fatigue severity scale in Parkinson’s disease patients. Arq Neuropsiquiatr. 2012 Jul;70(7):497-500. https://doi.org/10.1590/s0004-282x2012000700005
  • 16 Kummer A, Scalzo P, Cardoso F, Teixeira AL. Evaluation of fatigue in Parkinson’s disease using the Brazilian version of Parkinson’s Fatigue Scale. Acta Neurol Scand. 2011 Feb;123(2):130-6. https://doi.org/10.1111/j.1600-0404.2010.01364.x
  • 17 Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine (Phila Pa 1976). 2000 Dec;25(24):3186-91. https://doi.org/10.1097/00007632-200012150-00014
  • 18 Hughes AJ, Daniel SE, Blankson S, Lees AJ. A clinicopathologic study of 100 cases of Parkinson’s disease. Arch Neurol. 1993 Feb;50(2):140-8. https://doi.org/10.1001/archneur.1993.00540020018011
  • 19 Hoehn MM, Yahr MD. Parkinsonism: onset, progression and mortality. Neurology. 1967 May;17(5):427-42. https://doi.org/10.1212/wnl.17.5.427
  • 20 Folstein MF, Folstein SE, McHugh PR. “Mini-Mental State” - A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975 Nov;12(3):189-98. https://doi.org/10.1016/0022-3956(75)90026-6
  • 21 Goetz CG, Tilley BC, Shaftman SR, Stebbins GT, Fahn S, Martinez-Martin P, et al. Movement Disorder Society-Sponsored Revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS): scale presentation and clinimetric testing results. Mov Disord. 2008 Nov;23(15):2129-70. https://doi.org/10.1002/mds.22340
  • 22 Mokkink LB, Terwee CB, Patrick DL, Alonso J, Stratford PW, Knol DL, et al. The COSMIN study reached international consensus on taxonomy, terminology, and definitions of measurement properties for health-related patient-reported outcomes. J Clin Epidemiol. 2010 Jul;63(7):737-45. https://doi.org/10.1016/j.jclinepi.2010.02.006
  • 23 Yesavage JA, Brink TL, Rose TL, Lum O, Huang V, Adey M, et al. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res. 1982-1983;17(1):37-49. https://doi.org/10.1016/0022-3956(82)90033-4
  • 24 Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983 Jun;67(6):361-70. https://doi.org/10.1111/j.1600-0447.1983.tb09716.x
  • 25 Scientific Advisory Committee of the Medical Outcomes Trust. Instrument review criteria. Washington, D.C.: Scientific Advisory Committee, 1995.
  • 26 Smith SC, Lamping DL, Banarjee S, Harwood R, Foley B, Smith P, et al. Measurement of health-related quality of life for people with dementia: development of a new instrument (DEMQOL) and an evaluation of current methodology. Health Technol Assess. 2005 Mar;9(10):1-93, iii-iv. https://doi.org/10.3310/hta9100
  • 27 Terwee CB, Bot SD, De Boer MR, van der Windt DA, Knol DL, Dekker J, et al. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 2007 Jan;60(1):34-42. https://doi.org/10.1016/j.jclinepi.2006.03.012
  • 28 George D, Mallery P. SPSS for Windows step by step: a simple guide and reference, 11.0 update. 4th ed. Boston: Allyn & Bacon, 2003.
  • 29 Fisk JD, Brown MG, Sketris IS, Metz LM, Murray TJ, Stadnyk KJ. A comparison of health utility measures for the evaluation of multiple sclerosis treatments. J Neurol Neurosurg Psychiatry. 2005 Jan;76(1):58-63. https://doi.org/10.1136/jnnp.2003.017897
  • 30 Weeks A, Swerissen H, Belfrage J. Issues, challenges, and solutions in translating study instruments. Eval Rev. 2007 Apr;31(2):153-65. https://doi.org/10.1177/0193841X06294184
  • 31 Pavan K, Marangoni B, Mendes MF, Tilbery CP, Lianza S. Esclerose múltipla: adaptação transcultural e validação da escala modificada de impacto de fadiga. Arq Neuro-Psiquiatr. 2007;65(3a):669-73. https://doi.org/10.1590/S0004-282X2007000400024
  • 32 Guillemim F, Bombardier C, Beaton D. Cross-cultural adaptation of health-related quality of life measures: literature review and proposed guidelines. J Clin Epidemiol. 1993 Dec;46(12):1417-32. https://doi.org/10.1016/0895-4356(93)90142-n
  • 33 Elbers RY, Rietberg MB, van Wegen EE, Verhoef J, Kramer SF, Terwee CB et al. Self-report fatigue questionnaires in multiple sclerosis, Parkinson’s disease and stroke: a systematic review of measurement properties. Qual Life Res. 2012 Aug;21(6):925-44. https://doi.org/10.1007/s11136-011-0009-2
  • 34 Watson D, Clark LA. The PANAS-X: manual for the positive and negative affect schedule e expanded form. Iowa: University of Iowa, 1994.
  • 35 Çilga G, Genç A, Çolakoğlu BD, Kahraman T. Turkish adaptation of Parkinson fatigue scale and investigating its psychometric properties. Int J Rehabil Res. 2019 Mar;42(1):20-5. https://doi.org/10.1097/MRR.20200033202000330314
  • 36 Sáez-Francàs N, Hernández-Vara J, Corominas Roso M, Alegre Martín J, Casas Brugué M. The association of apathy with central fatigue perception in patients with Parkinson’s disease. Behav Neurosci. 2013 Apr;127(2):237-44. https://doi.org/10.1037/a0031531
  • 37 Martinez-Martin P, Wetmore JB, Arbelo JM, Catalán MJ, Valldeoriola F, Rodriguez-Blazquez C. Validation study of the Parkinson’s Fatigue Scale in advanced Parkinson’s disease. Patient Relat Outcome Meas. 2019;10:141-52. https://doi.org/10.2147/PROM.S196042
  • 38 Bensing JM, Hulsman RL, Schreurs KM. Gender differences in fatigue: biopsychosocial factors relating to fatigue in men and women. Med Care. 1999 Oct;37(10):1078-83. https://doi.org/10.1097/00005650-199910000-00011
  • 39 Hagell P, Rosblom T, Pålhagen S. A Swedish version of the 16-item Parkinson Fatigue Scale (PFS-16). Acta Neurol Scand. 2012 Apr;125(4):288-92. https://doi.org/10.1111/j.1600-0404.2011.01560.x
  • 40 Fu R, Cui SS, Du JJ, Huang P, He YC, Gao C, et al. Validation of the Parkinson Fatigue Scale in Chinese Parkinson’s disease patients. Brain Behav. 2017 May;7(6):e00712. https://doi.org/10.1002/brb3.712