Checklist Individual Strength Research Articles

Reliability and Validity of the Turkish Version of the Vanderbilt Fatigue Scale for Adults.

Listening-related fatigue (LRF) is a prominent topic of research interest. The purpose of this study is to investigate the reliability and validity of the Turkish version of the 40-item Vanderbilt Fatigue Scale for Adults (TR-VFS-A-40). This study included 317 adults with no hearing loss and 260 adults with hearing loss in the study group, totaling 577 adults aged 18-75 years. While 31 adults in the study group did not use any hearing technology, there were 96 hearing aid users and 123 cochlear implant (CI) users. A subset of 80 CI users completed the TR-VFS-A-40 a second time, 2 weeks later, to assess test-retest reliability. Intraclass correlation coefficients were used to assess test-retest reliability. Cronbach's alpha was used to evaluate internal consistency. To examine construct validity, a confirmatory factor analysis (CFA) was performed. For concurrent validity analysis, the Checklist Individual Strength (CIS) and TR-VFS-A-40 scores were analyzed using the Spearman correlation test. Cronbach's alpha values were excellent for the total scale of .987 and the cognitive, emotional, physical, and social subscales (.953, .954, .955, and .946, respectively). Analyses of concurrent validity revealed strong and significant correlations between CIS and TR-VFS-A-40 scores, indicating a good concurrent validity. The CFA determined that the construct validity of the TR-VFS-A-40 was satisfactory. The TR-VFS-A-40 is a valid and reliable measure of LRF. https://doi.org/10.23641/asha.25457752.

An 8-month adapted motor activity program in a young CMT1A male patient.

It is unclear whether prolonged periods of training can be well tolerated. In Charcot-Marie Tooth disease (CMT). We report the effects of an 8-month, adapted motor activity (AMA) program in a 16-years-old CMT1A male patient. The program included strength, mobility, and balance training (two sessions per week, 1h per session). Walking ability and walking velocity (Six-Minute Walking Test-6MWT, Ten Meters Walking Test-10mWT), balance (Y-Balance Test-YBT, Berg Balance Scale-BBS), functional mobility (Short Physical Performance Battery-Short physical performance battery), fatigue (Checklist Individual strength questionnaire - CIS20R), health and quality of life (Short Form Health Survey 36 questionnaire-SF-36) were evaluated in three moments: before (T0), after 5 (T1) and 8 (T2) months of adapted motor activity. Dorsal and plantar foot flexion strength (Maximal Voluntary Contraction-maximum voluntary contraction) and neuromuscular functions (Electromyography-sEMG, interpolated twitch technique-ITT) were measured at T1 and T2. Relative to T0, an amelioration of walking ability (6MWT, +9,3%) and balance (with improvements on Y-balance composite normalized mean reach of the right and left limb of 15,3% and 8,5%, respectively) was appreciable. Relative to T1, an increase in foot strength in three out of four movements (right plantar flexion, +39,3%, left plantar flexion, +22,7%, left dorsal flexion, 11,5%) was observed. Concerning voluntary muscle activation, a greater recruitment in the left, unlike right, medial gastrocnemius was observed. Results suggest the safety of an 8-month AMA program in a young patient affected by CMT1A.

A Self-Guided Web-Based App (MyDiaMate) for Enhancing Mental Health in Adults With Type 1 Diabetes: Insights From a Real-World Study in the Netherlands.

MyDiaMate is a web-based intervention specifically designed for adults with type 1 diabetes (T1D) that aims to help them improve and maintain their mental health. Prior pilot-testing of MyDiaMate verified its acceptability, feasibility, and usability. This study aimed to investigate the real-world uptake and usage of MyDiaMate in the Netherlands. Between March 2021 and December 2022, MyDiaMate was made freely available to Dutch adults with T1D. Usage (participation and completion rates of the modules) was tracked using log data. Users could volunteer to participate in the user profile study, which required filling out a set of baseline questionnaires. The usage of study participants was examined separately for participants scoring above and below the cutoffs of the "Problem Areas in Diabetes" (PAID-11) questionnaire (diabetes distress), the "World Health Organization Well-being Index" (WHO-5) questionnaire (emotional well-being), and the fatigue severity subscale of the "Checklist Individual Strength" (CIS) questionnaire (fatigue). Two months after creating an account, study participants received an evaluation questionnaire to provide us with feedback. In total, 1008 adults created a MyDiaMate account, of whom 343 (34%) participated in the user profile study. The mean age was 43 (SD 14.9; 18-76) years. Most participants were female (n=217, 63.3%) and higher educated (n=198, 57.6%). The majority had been living with T1D for over 5 years (n=241, 73.5%). Of the study participants, 59.1% (n=199) of them reported low emotional well-being (WHO-5 score≤50), 70.9% (n=239) of them reported elevated diabetes distress (PAID-11 score≥18), and 52.4% (n=178) of them reported severe fatigue (CIS score≥35). Participation rates varied between 9.5% (n=19) for social environment to 100% (n=726) for diabetes in balance, which opened by default. Completion rates ranged from 4.3% (n=1) for energy, an extensive cognitive behavioral therapy module, to 68.6% (n=24) for the shorter module on hypos. There were no differences in terms of participation and completion rates of the modules between study participants with a more severe profile, that is, lower emotional well-being, greater diabetes distress, or more fatigue symptoms, and those with a less severe profile. Further, no technical problems were reported, and various suggestions were made by study participants to improve the application, suggesting a need for more personalization. Data from this naturalistic study demonstrated the potential of MyDiaMate as a self-help tool for adults with T1D, supplementary to ongoing diabetes care, to improve healthy coping with diabetes and mental health. Future research is needed to explore engagement strategies and test the efficacy of MyDiaMate in a randomized controlled trial.

Different subtypes of chronic fatigue in childhood cancer survivors: A DCCSS LATER study.

The aim of the current study was to investigate whether subtypes of chronic fatigue (CF) can be identified in childhood cancer survivors (CCS), and if so, to determine the characteristics of participants with a specific subtype. Participants were included from the nationwide DCCSS LATER cohort. The Checklist Individual Strength (CIS) was completed to assess fatigue. Participants with CF (scored ≥35 on the fatigue severity subscale and indicated to suffer from fatigue for ≥6months) were divided into subgroups using two-step cluster analysis based on the CIS concentration, motivation, and physical activity subscales. Differences between groups on demographics, psychosocial, lifestyle, and treatment-related variables were determined using ANOVA and chi-square analyses (univariable) and multinomial regression analysis (multivariable). A total of 1910 participants participated in the current study (n=450 with CF; n=1460 without CF). Three CF subgroups were identified: Subgroup 1 (n=133, 29% of participants) had CF with problems in physical activity; Subgroup 2 (n=111, 25% of participants) had CF with difficulty concentrating; and Subgroup 3 (n=206, 46% of participants) had multi-dimensional CF. Compared to Subgroup 1, Subgroup 2 more often reported sleep problems, limitations in social functioning, and less often have more than two comorbidities. Subgroup 3 more often reported depression, sleep problems, a lower self-esteem, and limitations in social functioning and a lower educational level compared to Subgroup 1. Different subgroups of CCS with CF can be identified based on fatigue dimensions physical activity, motivation and concentration. Results suggest that different intervention strategies, tailored for each subgroup, might be beneficial.

Nocturnal vestibular stimulation using a rocking bed improves a severe sleep disorder in a patient with mitochondrial disease.

Mitochondrial diseases are rare genetic disorders often accompanied by severe sleep disorders. We present the case of a 12-year-old boy diagnosed with a severe primary mitochondrial disease, exhibiting ataxia, spasticity, progressive external ophthalmoplegia, cardiomyopathy and severely disrupted sleep, but no cognitive impairment. Interestingly, his parents reported improved sleep during night train rides. Based on this observation, we installed a rocking bed in the patient's bedroom and performed different interventions, including immersive multimodal vestibular, kinesthetic and auditory stimuli, reminiscent of the sensory experiences encountered during train rides. Over a 5-month period, we conducted four 2-week nocturnal interventions, separated by 1-week washout phases, to determine the subjectively best-perceived stimulation parameters, followed by a final 4-week intervention using the optimal parameters. We assessed sleep duration and quality using the Mini Sleep Questionnaire, monitored pulse rate changes and used videography to document nocturnal interactions between the patient and caregivers. Patient-reported outcome measures, clinical examinations and personal outcomes of specific interests were used to document daytime sleepiness, restlessness, anxiety, fatigue, cognitive performance and physical posture. In the final 4-week intervention, sleep duration increased by 25%, required caregiver interactions reduced by 75%, and caregiving time decreased by 40%. Subjective fatigue, assessed by the Checklist Individual Strength, decreased by 40%, falling below the threshold of severe fatigue. Our study suggests that rocking beds could provide a promising treatment regime for selected patients with persistent severe sleep disorders. Further research is required to validate these findings in larger patient populations with sleep disorders and other conditions.

Risk Perception and Fatigue in Port Workers: A Pilot Study.

The aims of this study were to assess fatigue in port workers; analyze the association between fatigue and levels of trust in organizations, as well as the association between authorities and risk perception; and examine the official documents governing the studied port, along with the current health and communication status of the port workers. This was a descriptive and cross-sectional pilot study, which presented quantitative and qualitative data, and it was carried out among port workers in the city of Pelotas, Rio Grande do Sul, Brazil. Thirty-nine port workers responded to quantitative questionnaires, which collected their socio-demographic data, as well as a risk perception questionnaire, the Chalder Fatigue Scale, and the Checklist of Individual Strength. Five documents from the port regiment were studied and qualitatively analyzed. The health communications consisted of presenting infographics with research data and providing information for reducing fatigue. Fifteen workers (38.5%) were considered fatigued. There was a reduction in fatigue associated with trust in the unions and the labor management body, and there was an agreement that the precarious environment was completely unacceptable. The qualitative data in the documents indicated that it was possible to identify the infrastructure of the port environment, the legislation, the strategies to be adopted in cases of natural disasters, emergency plans, plans for the protection and promotion of workers' health, individual and collective protection plans, the division of the sectors and those responsible for them, and documents detailing the hierarchy within the ports. The qualitative analysis culminated in graphic representations (infographics) created to communicate the research results to port workers, specifically in relation to fatigue, and we presented the ways to prevent fatigue at work. Discussion/Limitations: Studying the risk perceptions and fatigue levels of port workers through research with the active participation of these workers presented their lived experiences, which promoted discussion and perhaps more effective proposals to change their work conditions.

The validation of Chinese version of workplace PERMA-profiler and the association between workplace well-being and fatigue

BackgroundWell-being is an important issue in workplace. One of these assessment tools of well-being, Workplace PERMA Profiler, is based on Seligman’s five dimensions well-being. Prolonged fatigue may last for a long time, leading a great impact on both employees and enterprises. However, rare studies about the association between well-being and fatigue had been investigated. Our aim is to establish the Chinese version Profiler, and to discovery the association between workplace well-being and fatigue.MethodsThe Chinese version was established according to International Society of Pharmacoeconomics and Outcomes Research (ISPOR) task force guidelines. In the study, researchers employed simple random sampling by approaching individuals undergoing health checkups or receiving workplace health services, inviting them to participate in a questionnaire-based interview. Prolonged Fatigue was evaluated by Checklist Individual Strength (CIS). The reliability was evaluated by Cronbach’s alphas, Intra-class Correlation Coefficients (ICCs), and measurement errors. Moreover, confirmatory factor analysis and correlational analyses were assessed for the validity.ResultsThe analyses included 312 Chinese workers. Cronbach’s alphas of the Chinese version ranged from 0.69 to 0.93, while the ICC ranged from 0.70 to 0.92. The 5-factor model of confirmatory factor analysis revealed a nearly appropriate fit (χ2 (82) = 346.560, Comparative Fit Index [CFI] = 0.887, Tucker-Lewis Index [TLI] = 0.855, Root Mean Square Error of Approximation [RMSEA] = 0.114, Standardized Root Mean Square Residual [SRMR] = 0.060). Moreover, the CIS and its four dimensions were significantly and negatively associated with the Positive Emotion, while they are positively associated with Engagement dimension except CIS-Motivation dimension.ConclusionThe Chinese version Workplace PERMA-Profiler indicate nice reliability and validity. Furthermore, all CIS dimensions were negatively influenced by Positive Emotion, while commonly positively associated with Engagement.

P693 Care needs and reasons for (not) seeking care among fatigued patients with Inflammatory Bowel Disease: A qualitative study

Abstract Background Fatigue is one of the most prevalent and burdensome symptoms experienced by patients with inflammatory bowel disease (IBD), even when the disease is in remission. Many patients report dissatisfaction towards fatigue-related care and uptake of available interventions is often low. This study aims to explore reasons why IBD patients do or do not engage in professional fatigue-related care and their needs regarding type of care and how to offer care. Methods We conducted a qualitative study, taking a phenomenological methodological approach. Sixteen adult IBD patients with disease in remission and severe fatigue (i.e., Checklist Individual Strength – subjective fatigue ≥ 35) were recruited from an academic hospital. We performed semi-structured interviews. Data were analysed using template analyses. Results We identified six themes regarding reasons why to (not) seek care for fatigue: 1) cognitions about fatigue and coping (e.g., a need to deal with fatigue alone), 2) perceptions of fatigue-related care and previous care experiences (e.g., perceiving that nothing can be done about fatigue), 3) knowledge and behaviour of the healthcare provider (e.g., fatigue complaints are not taken seriously), 4) somatic factors (e.g., physical symptoms of IBD), 5) social factors (e.g., feeling misunderstood by others) and 6) practical factors (e.g., time and money). Furthermore, we identified needs regarding how to offer care, i.e., proactive screening and active offer of care by healthcare providers, a holistic and person-centred approach and practical needs taken into account. Finally, regarding what care to offer, patients suggested a broad range of options, including information provision on fatigue management, eliminating physical causes of fatigue, discussing medication options, lifestyle support, psychological support, peer support and practical support. Conclusion IBD patients’ perceptions, coping and knowledge, as well as healthcare professionals’ behaviours play a major role in seeking fatigue-related care. Findings emphasize the importance of discussing IBD-related fatigue actively and taking a holistic and patient-centred approach to treat fatigue, targeting a broad range of physical- and psychological factors. These findings yield a better understanding of factors that hinder and facilitate care seeking in fatigued IBD patients and hereby provide ways to optimize the uptake of care.

The comparison of functional status and health-related parameters in ovarian cancer survivors with healthy controls

PurposeThe primary purpose of this study was to evaluate functional status and health-related parameters in ovarian cancer (OC) survivors and to compare these parameters with healthy controls. The secondary purpose of this study was to compare these parameters in early and advanced OC survivors.MethodsThirty-two OC survivors (n = 15 early stage; n = 17 advanced stage) with no evidence/suspicion of cancer recurrence after completing adjuvant local and systemic treatments for at least 12 months and 32 healthy controls were recruited for functional- and health-related assessments. Participants were assessed using the following methods of measuring the following: 6-min walk test (6MWT) for functional exercise capacity, 30-s chair stand test (30 s-CST) for functional fitness and muscle endurance, a handheld dynamometer for peripheral muscle strength, and a handheld dynamometer for lower extremity strength, Medical Micro RPM for respiratory muscle strength, International Physical Activity Questionnaire-Short Form (IPAQ-SF) for physical activity level, and Eastern Cooperative Oncology Group Performance Scale (ECOG-PS) for performance status, Checklist Individual Strength (CIS) for fatigue, Treatment/Gynecological Oncology-Neurotoxicity (FACT/GOG-NTX) for neuropathy, the Hospital Anxiety and Depression Scale (HADS) for anxiety and depression level, and the World Health Organization-Five Well-Being Index (WHO-5) for generic quality of life.ResultsAll OC survivors underwent surgery and chemotherapy, and only 9.4% received radiotherapy in addition to chemotherapy. The median recurrence-free period post-completion of adjuvant treatments was 24.00 (12.00–75.00) months. OC survivors had lower 6MWT (m) (p < 0.001, r = 1.50), peripheral muscle strength (p = 0.005, r = 0.72), knee extension (p < 0.001, r = 1.54), and respiratory muscle strength (maximal inspiratory pressure) (p < 0.001, r = 1.90) (maximal expiratory pressure) (p < 0.001, r = 1.68) compared to healthy controls. HADS-A (p = 0.005, r = 0.75) and CIS scores (p = 0.025, r = 0.59) were also higher in the OC survivors. Early-stage OC survivors had better 6MWT (m) than advanced-stage OC survivors (p = 0.005, r = 1.83). Peripheral muscle strength was lower in advanced-stage OC survivors (p = 0.013, r = 0.92). FACT/GOG-NTX scores were higher in early-stage OC survivors (p < 0.001, r = 1.42). No significant differences were observed between early- and advanced-stage OC survivors in other measures (p < 0.05).ConclusionThe findings suggest functional status, and health-related parameters are negatively affected in OC survivors. Additionally, higher levels of fatigue, neuropathy anxiety, and depression were reported in advanced OC survivors.

Has COVID-19 really affected the physical and mental health of university students? One-year follow-up results after the pandemic declaration.

The COVID-19 pandemic affected the whole world and various isolation measures were applied during this period. One of the groups that were physically and mentally affected by this period was students. To investigate the effects of the COVID-19 pandemic on the physical activity (PA) level, attitudes and behaviors related to PA, smoking, perceived stress, and fatigue of university students one-year after the declaration of the pandemic. A total of 102 students (79F/23M, 20.68±1.81 years) who were evaluated face to face with International Physical Activity Questionnaire-Short Form (IPAQ-SF), Cognitive Behavioral Physical Activity Questionnaire (CBPAQ), Perceived Stress Scale (PSS), and Turkish Checklist Individual Strength (CIS-T) Questionnaire before the declaration of the pandemic, were evaluated online with the same questionnaires one-year after the declaration of the pandemic. Although there was no difference in terms of other variables, there was a statistically significant difference in the CBPAQ outcome expectation subscale (p = 0.04). The ΔPSS and ΔCIS-T total had a statistically significant effect on the ΔCBPAQ total (p = 0.003 and p = 0.007), ΔPSS and ΔCIS-T total were independent predictors of ΔCBPAQ total (Δ: before-one year after the declaration of the pandemic)CONCLUSION:University students had positive attitudes and behaviors related to PA and they increased their PA levels, although not significantly, compared to before the declaration of the pandemic. Perceived stress and fatigue may have an effect on attitudes and behaviors related to PA and PA levels. It is thought that university students continue their routines despite the many limitations of the pandemic.

Investigation of the Effects of Remote Online Exercise Training in Individuals Self-Isolating at Home Due to COVID-19 Disease: A Randomized Controlled Study

Objective: Effectiveness of a 4-week telerehabilitation program including thoracic expansion exercises (TEE), non-specific general body exercises (NSGBE), and physical activity recommendations (PAR) which started at quarantine in individuals with acute mild-COVID-19 was investigated in current study. Methods: This is a randomized controlled study which was performed between May 2021 and February 2022. Adult individuals with acute mild-COVID-19 were randomly grouped as training (TG) (telerehabilitation program under supervision for 3 days/week) and control (CG) (home program including TEE and PAR). Dyspnea (Modified Borg Scale and Modified Medical Research Council Dyspnea Scale), chronic fatigue (Checklist Individual Strength Questionnaire), anxiety and depression (Hospital Anxiety and Depression Scale), balance (Berg Functional Balance Scale) and lower body strength (a 30-s chair stand test) were evaluated remotely in the individuals before and after a 4-week follow-up. Results: Baseline characteristics and balance scores were similar between groups (p&gt;0.05). After 4-week from baseline, there were no significant differences in dyspnea, chronic fatigue, anxiety, depression, balance, and lower body strength between the groups (p&gt;0.05). However, as dyspnea, chronic fatigue, anxiety, and depression scores decreased, lower body strength increased significantly within TG after follow-up (p&lt;0.05). Dyspnea, chronic fatigue, and anxiety scores decreased while lower body strength increased significantly within CG after follow-up (p&lt;0.05). Conclusion: Dyspnea, severe fatigue, anxiety, and depression are commonly observed in individuals with mild-COVID-19 in the acute period. In these individuals, dyspnea perception, chronic fatigue, anxiety, depression, and functional performance improve after a 4-week light-intensity online tele-program applied either supervised or unsupervised. Mild exercises and PAR are safe and effective in these individuals.

Effectiveness of a blended booster programme for the long-term outcome of cognitive behavioural therapy for MS-related fatigue: A randomized controlled trial

Background: Cognitive behavioural therapy (CBT) reduces MS-related fatigue. However, studies on the long-term effects show inconsistent findings. Objective: To evaluate whether a blended booster programme improves the outcome of CBT for MS-related fatigue on fatigue severity at 1-year follow-up. Method: A multicentre randomized clinical trial in which 126 patients with MS were allocated to either a booster programme or no booster programme (control), after following 20-week tailored CBT for MS-related fatigue. Primary outcome was fatigue severity assessed with the Checklist Individual Strength fatigue subscale 1 year after start of treatment (T52). Mixed model analysis was performed by a statistician blinded for treatment-allocation to determine between-group differences in fatigue severity. Results: Fatigue severity at 1-year follow-up did not differ significantly between the booster (N = 62) and control condition (N = 64) (B = −2.01, 95% confidence interval (CI) = −4.76 to 0.75). No significant increase in fatigue severity was found at T52 compared with directly post-treatment (T20) in both conditions (B = 0.44, 95% CI = −0.97 to 1.85). Conclusion: Effects of CBT were sustained up to 1 year in both conditions. The booster programme did not significantly improve the long-term outcome of CBT for MS-related fatigue. Trial registration: Dutch Trial Register (NTR6966), registered 18 January 2018 https://www.trialregister.nl/trial/6782

Usability and feasibility of E-nergEYEze: a blended vision-specific E-health based cognitive behavioral therapy and self-management intervention to reduce fatigue in adults with visual impairment

BackgroundOver 50% of adults with visual impairment experience severe fatigue. Therefore, we developed a guided E-health intervention based on cognitive behavioral therapy and self-management to reduce fatigue in this population. This pilot study evaluated the usability, feasibility, fidelity and potential effectiveness of E-nergEYEze.MethodsE-nergEYEze was developed by a design team and customized by conducting a pilot study using an iterative development strategy. The intervention was first tested in a usability study among adults with visual impairment (n = 5). Participants were asked to think-aloud while exploring the intervention features and a semi-structured interview was performed afterwards. Subsequently, the enhanced intervention was tested in a feasibility study. Adults with visual impairment and severe fatigue (n = 10) followed the intervention partially with guidance from a social worker and one-time computer trainer support. Fatigue severity (Checklist Individual Strength), fatigue impact (Modified Fatigue Impact Scale) and cognitive behavioral therapy skills (Competencies of Cognitive Therapy Scale-Self Report) were measured at baseline and at three months follow-up and analyzed with the Wilcoxon signed-rank test. The intervention was evaluated through evaluation forms.ResultsThe usability study resulted in adjustments to content and lay-out with regard to optically shortened text sentences, separate pages for information and assignments with one read-aloud audio and an additional descriptive explanation of page content. Digital challenges were overcome with mandatory computer training and e-platform modifications. The feasibility study showed a positive trend in reducing fatigue severity (Z -6.108; P < .001; SD 8.4), impact of fatigue (Z − 4.451; P < .001; SD 11.4) and cognitive behavioral therapy skills (Z -2.278; P = .023; SD 19.3). Participants gave useful feedback regarding accessibility, content and guidance, with an overall positive experience. The intervention was rated with a median score of 8 (range 7–10).ConclusionWe developed, evaluated and optimized E-nergEYEze by applying a user-centered and iterative approach. E-nergEYEze showed a promising trend to reduce fatigue severity and impact of fatigue and to increase cognitive behavioral therapy skills. The study methods were feasible and the fidelity of the intervention protocol was suitable. Performing a randomized controlled trial is warranted to give insight into whether E-nergEYEze is cost-effective in reducing severe fatigue in adults with visual impairment.Trial registrationInternational Clinical Trial Registry Platform: NL7764. Date registered: 28-05-2019.

Does the effect of cognitive behavior therapy for chronic fatigue syndrome (ME/CFS) vary by patient characteristics? A systematic review and individual patient data meta-analysis.

Debate is ongoing on the efficacy of cognitive behavior therapy (CBT) for myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS). With an individual patient data (IPD) meta-analysis we investigated whether the effect of CBT varied by patient characteristics. These included post-exertional malaise (PEM), a central feature of ME/CFS according to many. We searched for randomized controlled trials similar with respect to comparison condition, outcomes and treatment-protocol. Moderation on fatigue severity (Checklist Individual Strength, subscale fatigue severity), functional impairment (Sickness Impact Profile-8) and physical functioning (Short Form-36, subscale physical functioning) was investigated using linear mixed model analyses and interaction tests. PROSPERO (CRD42022358245). Data from eight trials (n = 1298 patients) were pooled. CBT showed beneficial effects on fatigue severity (β = -11.46, 95% CI -15.13 to -7.79); p < 0.001, functional impairment (β = -448.40, 95% CI -625.58 to -271.23); p < 0.001; and physical functioning (β = 9.64, 95% CI 3.30 to 15.98); p < 0.001. The effect of CBT on fatigue severity varied by age (pinteraction = 0.003), functional impairment (pinteraction = 0.045) and physical activity pattern (pinteraction = 0.027). Patients who were younger, reported less functional impairments and had a fluctuating activity pattern benefitted more. The effect on physical functioning varied by self-efficacy (pinteraction = 0.025), with patients with higher self-efficacy benefitting most. No other moderators were found. It can be concluded from this study that CBT for ME/CFS can lead to significant reductions of fatigue, functional impairment, and physical limitations. There is no indication patients meeting different case definitions or reporting additional symptoms benefit less from CBT. Our findings do not support recent guidelines in which evidence from studies not mandating PEM was downgraded.

The Dutch registry for facioscapulohumeral muscular dystrophy: Cohort profile and longitudinal patient reported outcomes

Facioscapulohumeral dystrophy (FSHD) is the second most prevalent inherited muscular disorder and currently lacks a pharmaceutical treatment. The Dutch FSHD Registry was initiated in 2015 as a result of an international collaboration on trial readiness. This paper presents the cohort profile and six years of follow-up data of the registered FSHD patients. At the time of self-registration and every six months thereafter, participants were invited to complete a digital survey of patient and disease characteristics and the Dutch versions of the Checklist Individual Strength (CIS20R), the Individualised Neuromuscular Quality of Life Questionnaire (INQoL), the Beck Depression Index – Primary Care and the McGill Pain Questionnaire. From March 2015 to March 2021, 373 participants completed at least one survey. At baseline, fatigue and muscle weakness were the most frequently reported symptoms (median CIS20R sumscore 77 [IQR 60-92], median INQoL Fatigue score 58 [IQR 42-68] and median INQoL weakness score 58 [IQR 42-68]). Pain was experienced most often in the head and shoulder region (193, 52%). Nineteen of the 23 (sub)sections of questionnaires showed no significant changes over time. We conclude that the Dutch FSHD Registry was successfully set up, enabling collection of longitudinal data and facilitating recruitment in several studies.

Mental health up to 12 months following SARS-CoV-2 infection: A prospective cohort study

ObjectiveTo investigate to what extent individuals report clinically relevant levels of depression, anxiety, post-traumatic stress disorder (PTSD) symptoms and concentration problems up to 12 months following COVID-19 symptom onset, using validated questionnaires. MethodsRECoVERED, a prospective cohort study in Amsterdam, the Netherlands, enrolled both hospitalized and community-dwelling adult participants diagnosed with SARS-CoV-2. Symptoms of depression and anxiety were assessed with the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 1, 3, 6 and 12 months following illness onset. The DSM-V PTSD checklist was administered at month 3 and 9. Concentration problems were assessed using the Checklist Individual Strength concentration subscale at month 1 and 12. Generalized Estimating Equations were used to determine factors related with clinically relevant levels of depression-, anxiety- and PTSD-symptoms and concentration problems over time. ResultsIn 303 individuals, the prevalence of clinically relevant symptoms of depression, anxiety and concentration problems was 10.6% (95%CI = 7.2–15.4), 7.0% (95%CI = 4.4–11.2) and 33.6% (95%CI = 27.7–40.1), respectively, twelve months after infection. Nine months after illness onset, 4.2% (95%CI = 2.3–7.7) scored within the clinical range of PTSD. Risk factors for an increased likelihood of reporting mental health problems during follow up included initial severe/critical COVID-19, non-Dutch origin, psychological problems prior to COVID-19 and being infected during the first COVID-19 wave. ConclusionOur findings highlight that a minority of patients with COVID-19 face clinically relevant symptoms of depression, anxiety or PTSD up to 12 months after infection. The prevalence of concentration problems was high. This study contributes to the identification of specific groups for which support after initial illness is indicated.

A cross-cultural translation and validation of the Korean version of checklist individual strength (CIS) in the Korean working age population

Checklist Individual Strength (CIS) is a widely used questionnaire to measure a level of the chronic fatigue syndrome. The purpose of this study was to translate CIS into Korean and evaluate the reliability and validity of a Korean version of CIS (K–CIS) for the Korean working age population. In the first experimentation of the study, four bilingual translators participated to translate CIS using a cross-cultural translation method. Then, a concurrent validity of K–CIS with the original CIS was evaluated by 28 bilingual participants. With a statistical analysis, it was confirmed that K–CIS and CIS were linguistically equivalent. In the second experimentation, 172 participants from various universities, industries, and small businesses assessed K–CIS along with two other representative fatigue questionnaires such as mKCFQ11 and SF-36. Our result of the statistical analysis using Cronbach's α, confirmatory factor analysis, inter-scale correlation, and correlation with other questionnaires showed that K–CIS was a valid fatigue questionnaire. Therefore, we conclude that K–CIS can be an effective tool to evaluate a severity of fatigue in the Korean working age population.

Psychophysiology of Monotonous Driving, Fatigue and Sleepiness in Train and Non-Professional Drivers: Driver Safety Implications.

Fatigue and sleepiness are complex bodily states associated with monotony as well as physical and cognitive impairment, accidents, injury, and illness. Moreover, these states are often characteristic of professional driving. However, most existing work has focused on motor vehicle drivers, and research examining train drivers remains limited. As such, the present study psychophysiologically examined monotonous driving, fatigue, and sleepiness in a group of passenger train drivers and a group of non-professional drivers. Sixty-three train drivers and thirty non-professional drivers participated in the present study, which captured 32-lead electroencephalogram (EEG) data during a monotonous driving task. Fatigue and sleepiness were self-evaluated using the Pittsburgh Sleep Quality Index, the Epworth Sleepiness Scale, the Karolinksa Sleepiness Scale, and the Checklist of Individual Strength. Unexpectedly, fatigue and sleepiness scores did not significantly differ between the groups; however, train drivers generally scored lower than non-professional drivers, which may be indicative of individual and/or industry attempts to reduce fatigue. Across both groups, fatigue and sleepiness scores were negatively correlated with theta, alpha, and beta EEG variables clustered towards the fronto-central and temporal regions. Broadly, these associations may reflect a monotony-associated blunting of neural activity that is associated with a self-reported fatigue state.

OS08.5.A UNDERSTANDING THE ASSOCIATION BETWEEN FATIGUE AND COGNITION IN GLIOMA PATIENTS: AN OBSERVATIONAL MULTINATIONAL STUDY

Abstract BACKGROUND Both fatigue and cognitive impairment are highly prevalent in individuals with glioma and have been associated with diminished health-related quality of life. Although the two are thought to be related, evidence remains sparse, in part, due to the limited availability of data. Therefore, we aimed to investigate the relationship between fatigue and cognition in adult glioma patients. MATERIAL AND METHODS We analyzed cognitive data from adult patients with diffuse glioma at the University of California San Francisco (UCSF, n=100) and Amsterdam UMC (n=127). Comparable cognitive tests were combined by domain: attention, information processing, mental flexibility, semantic fluency, verbal learning, verbal memory, and visual search. Z-scores of ≤ -1.5 SD were considered impaired. Fatigue was assessed with the Fatigue Symptom Inventory (UCSF) and the Checklist Individual Strength (Amsterdam UMC). Linear mixed models were used to assess associations between cognitive domains and fatigue adjusted for site, grade, histology, sex, radiotherapy, and chemotherapy. Latent profile analysis was used to identify distinct fatigue-cognitive phenotypes. RESULTS UCSF patients were older (50.3 vs. 44.9 years, p=0.002), more likely to have grade 4 tumors (32% vs. 18%, p=0.025), and more years since diagnosis (2.72 vs 1.27, p&amp;lt;0.001). Interestingly, though UCSF patients were more impaired across nearly all cognitive domains, there was no difference in fatigue between institutions (-0.0457 vs. -0.178, p=0.60). Attention and impaired semantic fluency were associated with fatigue severity in univariate models. Using backward selection, the best-fit model included only impaired semantic fluency (estimated effect = 0.35, p= 0.014, r2=0.03). We identified four distinct cognitive phenotypes in the pooled dataset, which validated across sites, though fatigue severity did not contribute to these phenotypes. CONCLUSION Although fatigue and cognitive symptoms can overlap, the association between cognitive impairment and fatigue severity is weak. Interestingly, this important finding was validated across institutions and glioma subtypes. Further study is needed to address questions regarding the longitudinal change of symptoms. Given the limited relational overlap, fatigue and cognitive impairments should both be explicitly assessed and treated with targeted therapies. SUPPORT/DISCLOSURE Stichting Anita Veldman Foundation CCA-2019-2-21; Amsterdam University Fund 4056-2022-7-8; CCA travel grant 2022-10-10; Prins Bernhard Cultuurfondsbeurs 40042576/NOD; R.A. Laan fonds 2022-10-24; The loglio Collective; Sheri Sobrato Brisson Brain Cancer Survivorship Program.

Creatine and creatinine quantified using nuclear magnetic resonance: A method validation study and clinical associations between circulating creatine and fatigue in kidney transplant recipients

BackgroundA potential contributor to fatigue in kidney transplant recipients (KTR) may be impaired creatine homeostasis. We developed and validated a high-throughput NMR assay allowing for simultaneous measurement of circulating creatine and creatinine, and determined plasma creatine and estimated intramuscular creatine concentrations in KTRs, delineated their determinants and explored their associations with self-reported fatigue. MethodsAn NMR assay was developed and validated for measurement of circulating creatinine and creatine concentrations. Plasma creatine and creatinine concentrations were measured in 618 KTR. Fatigue was assessed using the checklist individual strength. Associations of creatine parameters with fatigue was assessed using linear mixed effect models. ResultsThe NMR-based assay had good sensitivity, precision and demonstrated linearity across a large range of values. Among KTR, the mean age was 56 ± 13 years, 62% were men and eGFR was 54 ± 18 ml/min/1.73 m2. Plasma creatine concentration was 27 [19–39] µmol/L. Estimated intramuscular creatine concentration was 27 ± 7 mmol/kg. Higher plasma creatine concentration and higher estimated intramuscular creatine concentration were independently associated with a lower total fatigue score and less motivation problems. ConclusionAn NMR method for measurement of circulating creatine and creatinine which offers the potential for accurate and efficient quantification was developed. The found associations suggest that improving creatine status may play a beneficial role in mitigating fatigue.