Abstract
Background: Attractor-based kinematic gait analysis using the Fatigue Index Kliniken Schmieder (FKS), have been suggested as a sensitive tool to determine motor fatigability in persons with Multiple Sclerosis (pwMS). Hypothesis: Depression does not affect the FKS to a similar degree as in pwMS. Methods: We recruited 32 patients with major depression. Data were collected with two accelerometers attached to both ankles. Data were recorded for one minute at the beginning and at the end of the treadmill test. Attractor attributes were used to analyze the data. Results: The mean Fatigue Index Kliniken Schmieder (FKS) was 2.1. The change of the attractor (δM) was 3.7 and the change of variability (δD) was 0.6. Mean values were clearly below values of pwMS with fatigability from a previous publication. However, the individual level values from six individuals—five of them showed pain related comorbidity besides depression—fell within the lower pathological range. There was no correlation between Hamilton depression scale and the attractor attributes (δM and δD). Discussion: Depression does not affect gait as motor fatigability does in pwMS. Results from subjects with pain during the treadmill test show a moderately increased variability and moderately altered attractors.
Highlights
Fatigue is a prominent and frequent symptom in persons with Multiple Sclerosis (MS)
Group results of gait analysis: Mean results of the attractor attributes fell within the normal range of non-fatiguing subjects as defined previously [11]
Correlation analysis between HDS and Fatigue Index Kliniken Schmieder (FKS): There was no significant correlation between the attractor attributes and the Hamilton Depression Scale (Figure 3)
Summary
Fatigue is a prominent and frequent symptom in persons with MS (pwMS). It affects up to ninety percent of patients [1] [2]. The discrimination between fatigue and fatigability has been a helpful differentiation [8]: Fatigue represents the subjective sensation of the patient. The following investigation addressed this hypothesis directly: to test whether the Fatigue Index Kliniken Schmieder (FKS) [12] is affected by depression or whether patients with major depression might have a false positive or pathological FKS. Attractor-based kinematic gait analysis using the Fatigue Index Kliniken Schmieder (FKS), have been suggested as a sensitive tool to determine motor fatigability in persons with Multiple Sclerosis (pwMS). Discussion: Depression does not affect gait as motor fatigability does in pwMS. Results from subjects with pain during the treadmill test show a moderately increased variability and moderately altered attractors
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