title: A 5-year longitudinal study of fatigue in patients with late-onset sequelae of poliomyelitis.
abstract: OBJECTIVE
  To study the severity and 5-year course of fatigue in patients with late-onset sequelae of poliomyelitis (LOSP) and to identify physical and psychosocial determinants of fatigue.
  
  
  METHODS
  Prospective cohort study with 5 measurements over 5 years.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  Patients with LOSP (N=168); 89% of the subjects completed the study.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Fatigue assessed with the Fatigue Severity Scale (FSS). Potential determinants were perceived physical functioning, bodily pain and mental health, extent of paresis, walking capacity, comorbidity, sleeping disorders, coping, and social support. Associations were investigated by multivariable longitudinal analysis using generalized estimating equations.
  
  
  RESULTS
  The mean FSS score ± SD at baseline was 5.1±1.4, which did not change significantly during the 5-year follow-up. Reduced physical functioning, increased bodily pain, reduced sleep quality, more psychologic distress, and higher task-oriented coping were independently associated with fatigue. The extent of paresis and walking capacity were strongly associated with physical functioning.
  
  
  CONCLUSIONS
  Fatigue is severe and persistent in patients with LOSP due to physical and psychologic factors, which has implications for counseling and treatment. In addition to the commonly applied interventions targeting physical aspects, psychologic interventions are a potential area for reducing fatigue.
authors.affiliation: Department of Rehabilitation, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. I.M.Tersteeg@amc.uva.nl
authors.forename: Irene M
authors.initials: IM
authors.lastname: Tersteeg
authors.forename: Fieke S
authors.initials: FS
authors.lastname: Koopman
authors.forename: Janneke M
authors.initials: JM
authors.lastname: Stolwijk-Swüste
authors.forename: Anita
authors.initials: A
authors.lastname: Beelen
authors.forename: Frans
authors.initials: F
authors.lastname: Nollet
mesh_terms: D000223:Adaptation, Psychological; D017668:Age of Onset; D000368:Aged; D005221:Fatigue / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016262:Postpoliomyelitis Syndrome / Q000453:epidemiology* / Q000523:psychology; D013997:Time Factors