Three distinct physical behavior types in fatigued patients with multiple sclerosis

H. E. M. Braakhuis; M. A. M. Berger; G. A. van der Stok; J. van Meeteren; V. de Groot; H. Beckerman; J. B. J. Bussmann; V. de Groot; H. Beckerman; A. Malekzadeh; L. E. van den Akker; M. Looijmans; S. A. Sanches; J. Dekker; E. H. Collette; B. W. van Oosten; C. E. Teunissen; M. A. Blankenstein; I. C. J. M. Eijssen; M. Rietberg; M. Heine; O. Verschuren; G. Kwakkel; J. M. A. Visser-Meily; I. G. L. van de Port; E. Lindeman; L. J. M. Blikman; J. van Meeteren; J. B. J. Bussmann; H. J. Stam; R. Q. Hintzen; H. G. A. Hacking; El Hoogervorst; S. T. F. M. Frequin; H. Knoop; B. A. de Jong; G. Bleijenberg; F. A. J. de Laat; M. C. Verhulsdonck; E. T. H. L. van Munster; C. J. Oosterwijk; G. J. Aarts

doi:10.1186/s12984-019-0573-1

Three distinct physical behavior types in fatigued patients with multiple sclerosis

H. E. M. Braakhuis^*, M. A. M. Berger, G. A. van der Stok, J. van Meeteren, V. de Groot, H. Beckerman, J. B. J. Bussmann, V. de Groot, H. Beckerman, A. Malekzadeh, L. E. van den Akker, M. Looijmans, S. A. Sanches, J. Dekker, E. H. Collette, B. W. van Oosten, C. E. Teunissen, M. A. Blankenstein, I. C. J. M. Eijssen, M. RietbergM. Heine, O. Verschuren, G. Kwakkel, J. M. A. Visser-Meily, I. G. L. van de Port, E. Lindeman, L. J. M. Blikman, J. van Meeteren, J. B. J. Bussmann, H. J. Stam, R. Q. Hintzen, H. G. A. Hacking, El Hoogervorst, S. T. F. M. Frequin, H. Knoop, B. A. de Jong, G. Bleijenberg, F. A. J. de Laat, M. C. Verhulsdonck, E. T. H. L. van Munster, C. J. Oosterwijk, G. J. Aarts

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

Background Multiple sclerosis often leads to fatigue and changes in physical behavior (PB). Changes in PB are often assumed as a consequence of fatigue, but effects of interventions that aim to reduce fatigue by improving PB are not sufficient. Since the heterogeneous nature of MS related symptoms, levels of PB of fatigued patients at the start of interventions might vary substantially. Better understanding of the variability by identification of PB subtypes in fatigued patients may help to develop more effective personalized rehabilitation programs in the future. This study aimed to identify PB subtypes in fatigued patients with multiple sclerosis based on multidimensional PB outcome measures. Methods Baseline accelerometer (Actigraph) data, demographics and clinical characteristics of the TREFAMS-ACE participants (n = 212) were used for secondary analysis. All patients were ambulatory and diagnosed with severe fatigue based on a score of >= 35 on the fatigue subscale of the Checklist Individual Strength (CIS20r). Fifteen PB measures were used derived from 7 day measurements with an accelerometer. Principal component analysis was performed to define key outcome measures for PB and two-step cluster analysis was used to identify PB types. Results Analysis revealed five key outcome measures: percentage sedentary behavior, total time in prolonged moderate-to-vigorous physical activity, number of sedentary bouts, and two types of change scores between day parts (morning, afternoon and evening). Based on these outcomes three valid PB clusters were derived. Conclusions Patients with severe MS-related fatigue show three distinct and homogeneous PB subtypes. These PB subtypes, based on a unique set of PB outcome measures, may offer an opportunity to design more individually-tailored interventions in rehabilitation.

Original language	English
Number of pages	9
Journal	Journal of NeuroEngineering and Rehabilitation
Volume	16
Issue number	1
DOIs	https://doi.org/10.1186/s12984-019-0573-1
Publication status	Published - 23 Aug 2019

Bibliographical note

Funding:
The TREFAMS study is supported by Fonds NutsOhra (grant no. 89000005).
Part of the current study is financially supported by Rijndam Rehabilitation,
Rotterdam, The Netherlands

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Braakhuis, H. E. M., Berger, M. A. M., van der Stok, G. A., van Meeteren, J., de Groot, V., Beckerman, H., Bussmann, J. B. J., de Groot, V., Beckerman, H., Malekzadeh, A., van den Akker, L. E., Looijmans, M., Sanches, S. A., Dekker, J., Collette, E. H., van Oosten, B. W., Teunissen, C. E., Blankenstein, M. A., Eijssen, I. C. J. M., ... Aarts, G. J. (2019). Three distinct physical behavior types in fatigued patients with multiple sclerosis. Journal of NeuroEngineering and Rehabilitation, 16(1). https://doi.org/10.1186/s12984-019-0573-1

@article{b58f6b3e4ab948689d6078e1439d633d,

title = "Three distinct physical behavior types in fatigued patients with multiple sclerosis",

abstract = "Background Multiple sclerosis often leads to fatigue and changes in physical behavior (PB). Changes in PB are often assumed as a consequence of fatigue, but effects of interventions that aim to reduce fatigue by improving PB are not sufficient. Since the heterogeneous nature of MS related symptoms, levels of PB of fatigued patients at the start of interventions might vary substantially. Better understanding of the variability by identification of PB subtypes in fatigued patients may help to develop more effective personalized rehabilitation programs in the future. This study aimed to identify PB subtypes in fatigued patients with multiple sclerosis based on multidimensional PB outcome measures. Methods Baseline accelerometer (Actigraph) data, demographics and clinical characteristics of the TREFAMS-ACE participants (n = 212) were used for secondary analysis. All patients were ambulatory and diagnosed with severe fatigue based on a score of >= 35 on the fatigue subscale of the Checklist Individual Strength (CIS20r). Fifteen PB measures were used derived from 7 day measurements with an accelerometer. Principal component analysis was performed to define key outcome measures for PB and two-step cluster analysis was used to identify PB types. Results Analysis revealed five key outcome measures: percentage sedentary behavior, total time in prolonged moderate-to-vigorous physical activity, number of sedentary bouts, and two types of change scores between day parts (morning, afternoon and evening). Based on these outcomes three valid PB clusters were derived. Conclusions Patients with severe MS-related fatigue show three distinct and homogeneous PB subtypes. These PB subtypes, based on a unique set of PB outcome measures, may offer an opportunity to design more individually-tailored interventions in rehabilitation.",

author = "Braakhuis, {H. E. M.} and Berger, {M. A. M.} and {van der Stok}, {G. A.} and {van Meeteren}, J. and {de Groot}, V. and H. Beckerman and Bussmann, {J. B. J.} and {de Groot}, V. and H. Beckerman and A. Malekzadeh and {van den Akker}, {L. E.} and M. Looijmans and Sanches, {S. A.} and J. Dekker and Collette, {E. H.} and {van Oosten}, {B. W.} and Teunissen, {C. E.} and Blankenstein, {M. A.} and Eijssen, {I. C. J. M.} and M. Rietberg and M. Heine and O. Verschuren and G. Kwakkel and Visser-Meily, {J. M. A.} and {van de Port}, {I. G. L.} and E. Lindeman and Blikman, {L. J. M.} and {van Meeteren}, J. and Bussmann, {J. B. J.} and Stam, {H. J.} and Hintzen, {R. Q.} and Hacking, {H. G. A.} and El Hoogervorst and Frequin, {S. T. F. M.} and H. Knoop and {de Jong}, {B. A.} and G. Bleijenberg and {de Laat}, {F. A. J.} and Verhulsdonck, {M. C.} and {van Munster}, {E. T. H. L.} and Oosterwijk, {C. J.} and Aarts, {G. J.}",

note = "Funding: The TREFAMS study is supported by Fonds NutsOhra (grant no. 89000005). Part of the current study is financially supported by Rijndam Rehabilitation, Rotterdam, The Netherlands",

year = "2019",

month = aug,

day = "23",

doi = "10.1186/s12984-019-0573-1",

language = "English",

volume = "16",

journal = "Journal of NeuroEngineering and Rehabilitation",

issn = "1743-0003",

publisher = "BioMed Central Ltd.",

number = "1",

}

Braakhuis, HEM, Berger, MAM, van der Stok, GA, van Meeteren, J, de Groot, V, Beckerman, H, Bussmann, JBJ, de Groot, V, Beckerman, H, Malekzadeh, A, van den Akker, LE, Looijmans, M, Sanches, SA, Dekker, J, Collette, EH, van Oosten, BW, Teunissen, CE, Blankenstein, MA, Eijssen, ICJM, Rietberg, M, Heine, M, Verschuren, O, Kwakkel, G, Visser-Meily, JMA, van de Port, IGL, Lindeman, E, Blikman, LJM, van Meeteren, J , Bussmann, JBJ , Stam, HJ, Hintzen, RQ, Hacking, HGA, Hoogervorst, E, Frequin, STFM, Knoop, H, de Jong, BA, Bleijenberg, G, de Laat, FAJ, Verhulsdonck, MC, van Munster, ETHL, Oosterwijk, CJ & Aarts, GJ 2019, 'Three distinct physical behavior types in fatigued patients with multiple sclerosis', Journal of NeuroEngineering and Rehabilitation, vol. 16, no. 1. https://doi.org/10.1186/s12984-019-0573-1

TY - JOUR

T1 - Three distinct physical behavior types in fatigued patients with multiple sclerosis

AU - Braakhuis, H. E. M.

AU - Berger, M. A. M.

AU - van der Stok, G. A.

AU - van Meeteren, J.

AU - de Groot, V.

AU - Beckerman, H.

AU - Bussmann, J. B. J.

AU - de Groot, V.

AU - Beckerman, H.

AU - Malekzadeh, A.

AU - van den Akker, L. E.

AU - Looijmans, M.

AU - Sanches, S. A.

AU - Dekker, J.

AU - Collette, E. H.

AU - van Oosten, B. W.

AU - Teunissen, C. E.

AU - Blankenstein, M. A.

AU - Eijssen, I. C. J. M.

AU - Rietberg, M.

AU - Heine, M.

AU - Verschuren, O.

AU - Kwakkel, G.

AU - Visser-Meily, J. M. A.

AU - van de Port, I. G. L.

AU - Lindeman, E.

AU - Blikman, L. J. M.

AU - van Meeteren, J.

AU - Bussmann, J. B. J.

AU - Stam, H. J.

AU - Hintzen, R. Q.

AU - Hacking, H. G. A.

AU - Hoogervorst, El

AU - Frequin, S. T. F. M.

AU - Knoop, H.

AU - de Jong, B. A.

AU - Bleijenberg, G.

AU - de Laat, F. A. J.

AU - Verhulsdonck, M. C.

AU - van Munster, E. T. H. L.

AU - Oosterwijk, C. J.

AU - Aarts, G. J.

N1 - Funding: The TREFAMS study is supported by Fonds NutsOhra (grant no. 89000005). Part of the current study is financially supported by Rijndam Rehabilitation, Rotterdam, The Netherlands

PY - 2019/8/23

Y1 - 2019/8/23

N2 - Background Multiple sclerosis often leads to fatigue and changes in physical behavior (PB). Changes in PB are often assumed as a consequence of fatigue, but effects of interventions that aim to reduce fatigue by improving PB are not sufficient. Since the heterogeneous nature of MS related symptoms, levels of PB of fatigued patients at the start of interventions might vary substantially. Better understanding of the variability by identification of PB subtypes in fatigued patients may help to develop more effective personalized rehabilitation programs in the future. This study aimed to identify PB subtypes in fatigued patients with multiple sclerosis based on multidimensional PB outcome measures. Methods Baseline accelerometer (Actigraph) data, demographics and clinical characteristics of the TREFAMS-ACE participants (n = 212) were used for secondary analysis. All patients were ambulatory and diagnosed with severe fatigue based on a score of >= 35 on the fatigue subscale of the Checklist Individual Strength (CIS20r). Fifteen PB measures were used derived from 7 day measurements with an accelerometer. Principal component analysis was performed to define key outcome measures for PB and two-step cluster analysis was used to identify PB types. Results Analysis revealed five key outcome measures: percentage sedentary behavior, total time in prolonged moderate-to-vigorous physical activity, number of sedentary bouts, and two types of change scores between day parts (morning, afternoon and evening). Based on these outcomes three valid PB clusters were derived. Conclusions Patients with severe MS-related fatigue show three distinct and homogeneous PB subtypes. These PB subtypes, based on a unique set of PB outcome measures, may offer an opportunity to design more individually-tailored interventions in rehabilitation.

AB - Background Multiple sclerosis often leads to fatigue and changes in physical behavior (PB). Changes in PB are often assumed as a consequence of fatigue, but effects of interventions that aim to reduce fatigue by improving PB are not sufficient. Since the heterogeneous nature of MS related symptoms, levels of PB of fatigued patients at the start of interventions might vary substantially. Better understanding of the variability by identification of PB subtypes in fatigued patients may help to develop more effective personalized rehabilitation programs in the future. This study aimed to identify PB subtypes in fatigued patients with multiple sclerosis based on multidimensional PB outcome measures. Methods Baseline accelerometer (Actigraph) data, demographics and clinical characteristics of the TREFAMS-ACE participants (n = 212) were used for secondary analysis. All patients were ambulatory and diagnosed with severe fatigue based on a score of >= 35 on the fatigue subscale of the Checklist Individual Strength (CIS20r). Fifteen PB measures were used derived from 7 day measurements with an accelerometer. Principal component analysis was performed to define key outcome measures for PB and two-step cluster analysis was used to identify PB types. Results Analysis revealed five key outcome measures: percentage sedentary behavior, total time in prolonged moderate-to-vigorous physical activity, number of sedentary bouts, and two types of change scores between day parts (morning, afternoon and evening). Based on these outcomes three valid PB clusters were derived. Conclusions Patients with severe MS-related fatigue show three distinct and homogeneous PB subtypes. These PB subtypes, based on a unique set of PB outcome measures, may offer an opportunity to design more individually-tailored interventions in rehabilitation.

UR - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=eur_pure&SrcAuth=WosAPI&KeyUT=WOS:000483532700001&DestLinkType=FullRecord&DestApp=WOS

U2 - 10.1186/s12984-019-0573-1

DO - 10.1186/s12984-019-0573-1

M3 - Article

C2 - 31443714

SN - 1743-0003

VL - 16

JO - Journal of NeuroEngineering and Rehabilitation

JF - Journal of NeuroEngineering and Rehabilitation

IS - 1

ER -

Three distinct physical behavior types in fatigued patients with multiple sclerosis

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