Self-report fatigue questionnaires in multiple sclerosis, Parkinson's disease and stroke: a systematic review of measurement properties.
OBJECTIVE
To critically appraise, compare and summarize the measurement properties of self-report fatigue questionnaires validated in patients with multiple sclerosis (MS), Parkinson's disease (PD) or stroke.


METHODS
MEDLINE, EMBASE, PsycINFO, CINAHL and SPORTdiscus were searched. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist was used to assess the methodological quality of studies. A qualitative data synthesis was performed to rate the measurement properties for each questionnaire.


RESULTS
Thirty-eight studies out of 5,336 records met the inclusion criteria, evaluating 31 questionnaires. Moderate evidence was found for adequate internal consistency and structural validity of the Fatigue Scale for Motor and Cognitive functions (FSMC) and for adequate reliability and structural validity of the Unidimensional Fatigue Impact Scale (U-FIS) in MS.


CONCLUSIONS
We recommend the FSMC and U-FIS in MS. The Functional Assessment of Chronic Illness Therapy Fatigue subscale (FACIT-F) and Fatigue Severity Scale (FSS) show promise in PD, and the Profile of Mood States Fatigue subscale (POMS-F) for stroke. Future studies should focus on measurement error, responsiveness and interpretability. Studies should also put emphasis on providing input for the theoretical construct of fatigue, allowing the development of questionnaires that reflect generic and disease-specific symptoms of fatigue.
Department of Physiotherapy, University of Applied Sciences Leiden, Zernikedreef 11, PO Box 382, 2300 AJ, Leiden, The Netherlands. elbers.r@hsleiden.nl
Roy G
RG
Elbers
Marc B
MB
Rietberg
Erwin E H
EE
van Wegen
John
J
Verhoef
Sharon F
SF
Kramer
Caroline B
CB
Terwee
Gert
G
Kwakkel
D005221:Fatigue / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D009103:Multiple Sclerosis / Q000150:complications*; D010300:Parkinson Disease / Q000150:complications*; D011594:Psychometrics / Q000295:instrumentation*; D015203:Reproducibility of Results; D057566:Self Report; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications*; D011795:Surveys and Questionnaires; D054928:Validation Studies as Topic