title: Relationship between neuromuscular and perceived fatigue and locomotor performance in patients with multiple sclerosis.
abstract: BACKGROUND
  Fatigue is a common problem in patients with multiple sclerosis; however, the impact of neuromuscular and perceived fatigue on locomotor performance is currently unknown in these patients.
  
  
  OBJECTIVE
  The aim of this study was: 1) to determine the relationship between perceived and neuromuscular fatigue and locomotor performance in patients with multiple sclerosis; 2) to determine if neuromuscular and perceived fatigue depend on the severity of the pathology defined by the Expanded disability status scale score (EDSS).
  
  
  METHODS
  Observational study.
  
  
  METHODS
  Outpatients from a hospital rehabilitation department.
  
  
  METHODS
  Thirty patients with multiple sclerosis underwent clinical (spasticity, strength, perceived fatigue and locomotor performance) and isokinetic evaluations (peak torque of knee flexor and extensor muscles and neuromuscular fatigue of knee extensor muscles).
  
  
  METHODS
  The main outcome measures were perceived and neuromuscular fatigue and locomotor performance. Secondary outcomes were strength of the weakest limb and peak isometric torque of knee flexor and extensor muscles, spasticity, EDSS.
  
  
  RESULTS
  There were no significant correlations between perceived or neuromuscular fatigue and locomotor performance. Locomotor performance was correlated with EDSS, spasticity, strength of the weakest limb and peak isometric torque of knee flexor and extensor muscles. Eighty‑three percent of the variance of the 6MWT could be explained by EDSS score, strength of the weakest limb (MRCsum), torque produced during the last five contractions of the fatigue protocol and peak isometric torque of knee flexor muscles. Patients with moderate disability (EDSS Score 4-6) had greater levels of neuromuscular fatigue than patients with mild disability (<4).
  
  
  CONCLUSIONS
  Although fatigue is a disabling symptom of multiple sclerosis, and neuromuscular fatigue was found to be higher in more disabled patients, locomotor performance was correlated with strength and spasticity but not with fatigue.
  
  
  CONCLUSIONS
  Nevertheless, fatigue was related to 6MWT performance since torque produced during the last five contractions of the fatigue protocol was one of the factors which explained performance.
authors.affiliation: Inserm Unit 1179, Team 3: Technology and Innovative Therapies Applied to Neuromuscular Diseases, Université de Versailles Saint Quentin en Yvelines, Garches, France - sophie.hameau@aphp.fr.|Department of Physical Medicine and Rehabilitation, R. Poincaré hospital (AP‑HP), Garches, France - sophie.hameau@aphp.fr.
authors.forename: Sophie
authors.initials: S
authors.lastname: Hameau
authors.affiliation: Laboratory of Human Motricity, Sport, Education and Health (EA 6312), University of Nice Sophia Antipolis, Nice, France.
authors.forename: Raphael
authors.initials: R
authors.lastname: Zory
authors.affiliation: Inserm Unit 1179, Team 3: Technology and Innovative Therapies Applied to Neuromuscular Diseases, Université de Versailles Saint Quentin en Yvelines, Garches, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Latrille
authors.affiliation: Inserm Unit 1179, Team 3: Technology and Innovative Therapies Applied to Neuromuscular Diseases, Université de Versailles Saint Quentin en Yvelines, Garches, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Roche
authors.affiliation: Inserm Unit 1179, Team 3: Technology and Innovative Therapies Applied to Neuromuscular Diseases, Université de Versailles Saint Quentin en Yvelines, Garches, France.|Department of Physical Medicine and Rehabilitation, R. Poincaré hospital (AP‑HP), Garches, France.
authors.forename: Djamel
authors.initials: D
authors.lastname: Bensmail
mesh_terms: D000328:Adult; D017079:Exercise Tolerance / Q000502:physiology*; D005221:Fatigue / Q000209:etiology / Q000503:physiopathology* / Q000523:psychology; D005260:Female; D006801:Humans; D007719:Knee Joint; D008124:Locomotion / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications / Q000503:physiopathology* / Q000523:psychology*; D018763:Muscle Fatigue / Q000502:physiology*; D009128:Muscle Spasticity / Q000209:etiology / Q000503:physiopathology / Q000523:psychology; D053580:Muscle Strength / Q000502:physiology; D016059:Range of Motion, Articular