Accepted for/Published in: JMIR Rehabilitation and Assistive Technologies
Date Submitted: Jun 11, 2021
Open Peer Review Period: Jun 11, 2021 - Aug 6, 2021
Date Accepted: Dec 22, 2021
(closed for review but you can still tweet)
Behavioral clusters derived by actigraphy show differences in reported levels of fatigue in multiple sclerosis: A cross-sectional study
ABSTRACT
Background:
Persons with multiple sclerosis (pwMS) frequently report increased levels of fatigue and fatigability. However, behavioral surrogates that are strongly associated with self-reports are lacking.
Objective:
Our aim was to derive behavioral stereotypes that are reflected by self-reports concerning fatigue and fatigability.
Methods:
We collected actigraphic data of 30 pwMS over one week during an inpatient stay at a neurorehabilitation facility. Further, participants filled out the German fatigue severity scale. A principal component analysis of actigraphic parameters was performed to extract latent component levels of behaviors that reflect fatigue (quantity of activity) and fatigability (fragmentation of activity). The resulting components were used in a cluster analysis.
Results:
Analyses suggested three clusters. One with high activity (d=0.65-1.57) and low clinical disability levels (d=0.91-1.39), one with high levels of sedentary behavior (1.06-1.58), and one with strong activity fragmentation (1.39-1.94). The cluster with high levels of sedentary behavior further revealed strong differences to the other clusters concerning their reported levels of fatigue (d=0.99-1.28).
Conclusions:
Cluster analysis data proved to be feasible to differentiate between different behavioral stereotypes. Self-reports reflected those in a strong manor. Testing of additional domains (e.g., volition or processing speed) and assessments during everyday life seem warranted in order to better understand the origins of reported fatigue symptomatology.
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