Fatigue Category Research Articles

Minimize Mental Workload and Fatigue of Horizontal Directional Drilling Worker Using Rating Scale Mental Effort and Swedish Occupational Fatigue Inventory Methods.

Horizontal Directional Drilling (HDD) is a drilling technique that does not damage the groundsurface; the HDD process involves a stage that requires high concentration and physical skills and isoften carried out in challenging working conditions, causing mental Workload and fatigue in HDDworkers. HDD workers should be given improvements in their work methods to be safe whenworking due to being too tired or losing focus. HDDs must be monitored in real-time, which requiresworkers to get good results without errors so that workers experience workload pressure andmental fatigue. This study aims to measure and minimize mental Workload and fatigue in HDDworkers and determine improvement proposals based on the why-why diagram. Mental workloadmeasurement using the RSME method and fatigue using SOFI and why diagrams are used to findcause and effect in mental Workload and fatigue experienced by HDD workers. Based on the analysisof RSME, the scale value obtained based on six indicators of WL, WD, WP, WME, WA, and WF is 92.05,which is in the category of enormous business carried out, and the KiK indicator or fatigue gets thehighest scale value of 106.52 with the business category given is very large so that HDD workersexperience a mental workload. Mental workload and fatigue correlate. Based on the results of SOFI,the sleepiness dimension received a score of 21.83 with a high level of fatigue category. Therefore,the proposed improvement to the causal results of the Why Diagram is adding the workforce,adjusting work shifts, and monitoring and evaluating HDD workers.

Experimental study on low-cycle fatigue performance of high-strength bolted shear connections

In strong earthquakes, low-cycle fatigue fractures may occur in the bolted connections of steel braced frames. Ensuring a high low-cycle fatigue life for high-strength bolted connections is of paramount significance in enhancing the overall safety and collapse resistance of steel structures. Despite substantial research on plate fatigue failure within bolted connections, there remains a research gap regarding low-cycle fatigue failure of high-strength bolts in these connections. This study aims to address the aforementioned shortcomings by conducting 34 sets of low-cycle fatigue tests on high-strength bolted connections. The test specimens all experienced low-cycle shear fatigue fracture at the threaded or unthreaded portion of the bolt shank as the dominant failure mode. Residual deformations were observed in the holes of connection plates. Based on the test data, ultimate shear capacity of a single shear connection is around 0.61Fy (tensile yield bearing capacity of bolt) when the shear force passes through the unthreaded portion and drops to 0.54Fy for the shear force at the thread. The untreated Q355 (minimum yield strength of 355 MPa) steel surface has an average anti-slip coefficient of around 0.37, while milling reduces it to approximately 0.30. The influence patterns of loading amplitude, bolt material, minimum plate thickness, bolt diameter, shear force position and connection type on low-cycle fatigue life are given by range analysis. Among them, variance analysis shows that loading amplitude and bolt material are the primary influencing factors. The correlation coefficient between loading amplitude and low-cycle fatigue life is −0.92, indicating a strong negative correlation. The degradation amount and rate of anti-slip capacity and shear capacity of bolted connections are also investigated. To propose reliable life prediction method, three models were used to establish the relationship between dimensionless shear deformation and low-cycle fatigue life of 10.9-grade high-strength bolted connections. It is not appropriate to use the fatigue categories defined in current standards to predict the low-cycle shear fatigue life of high-strength bolted connections.

The relationship between self-perceived fatigue, muscle endurance, and circulating markers of inflammation in participants of the Copenhagen aging and Midlife Biobank (CAMB)

BackgroundFatigue, low muscle endurance, muscle weakness and low-grade inflammation are strongly related to frailty at higher age. When signs of self-perceived fatigue and low muscle endurance are interrelated with low-grade inflammation at midlife, they might be used as early markers for frailty. This study investigated whether the interrelationships among self-perceived fatigue, muscle endurance and inflammation can be observed at midlife.MethodsA total of 965 participants of the Copenhagen Aging and Midlife Biobank (aged 52 ± 4 years, 536 males, 426 females) were assessed for self-perceived fatigue (20-item multidimensional fatigue inventory), muscle endurance (grip work), circulating markers of inflammation (hsCRP, IL-6, IL-10, TNF-alpha and IFN-γ), daily physical activity (PAS-2), body composition (%body fat assessed by bio-impedance) and self-reported health status. Participants were categorised (correcting for age and gender) according to high fatigue and/or low muscle endurance, differences in inflammatory profile between fatigue categories were assessed by ANCOVA (corrected for PAS-2, %body fat and presence of inflammatory conditions).ResultsOverall, muscle endurance, fatigue and inflammatory markers were significantly interrelated. Higher levels of hsCRP (p < 0.001), IL-6 (p < 0.001), IL-10 (p = 0.035) and TNF-alpha (p = 0.028) were observed in participants presenting both low muscle endurance and high fatigue. IFN-γ was highest in those with high fatigue but normal muscle endurance (p = 0.015).ConclusionsMiddle-aged participants with higher fatigue in combination with low muscle endurance show higher levels of inflammation, independently from physical activity, body fat and inflammatory pathology. The underlying mechanisms should be identified and future studies should also investigate whether these individuals show early signs of reduced physiological reserve capacity, which in later life come to full expression by means of frailty.

Considerations regarding the fatigue design of the steel bridges

The fatigue damage of steel bridges is prone to occur under a large amount of heavy traffic and be a worldwide problem leading to serious disasters. This communication will discuss the importance of the correct evaluation of the fatigue category of resistance for the safety and durability of bridges. Although much attention is usually rightly paid by engineers to the effects of traffic, on the other hand the effect of stress concentrations which modify the category of detail of the tables of the Eurocode is still very poorly known.We will deal with multiple examples to illustrate the question: the replacement of the cylinder head of the François I bridge in Le Havre at the very beginning of the 80s is an excellent example of an approach to the calculation of stress concentration factors by finite elements, which made it possible to solve the fatigue problems of this movable bridge.On the other hand, the cracking of the bridges of Chamousset where a then forbidden constructive arrangement was nevertheless built shows that the question is not a view of the mind: If the problem had not been identified and the bridge put under annual surveillance for the hot spots concerned, the two bridges could have collapsed.Today, Clause 7.1(5) of the French National Annex to EC3 1-9 has put manufacturers under the obligation to take into account stress concentration factors since 2011. Several features will be reviewed, such as for example the thickness transition zones with and without cope hole, the anchorages of hangers, the studs under tension and bending, the bottom cuts of the vertical stiffeners that actually do not help regarding fatigue, and the interruptions of guide rails.Finally, the effects of corrosion, in particular the case of the weathering steels when used in the transition zones will be discussed in detail using models using the “Effective Notch Stress Method” based on tests carried out on samples for the Academy of Sciences of the Czech Republic by Ludwig Kunz. Of course, the aging of weathering steels in case of birds droppings is not considered in this study. Even without birds droppings, the fatigue resistance of some weathering steels details has to be reduced considering the Clause 7.1(5) of the French National Annex to EC3 1-9 when compared to the categories given by the tables of the Eurocodes for painted details.

Self-Reported Fatigue by the Chalder Fatigue Questionnaire and Mortality in Brazilian Hemodialysis Patients: The PROHEMO

Background: The existing data support the Chalder Fatigue Questionnaire (CFQ-11) as a valid instrument to assess fatigue in maintenance hemodialysis (MHD) patients. The objective of this work was to investigate whether self-reported fatigue can serve as an independent prognostic indicator for mortality in MHD patients. Methods: The data are from 233 adult patients enrolled in the cohort “The Prospective Study of the Prognosis of Chronic Hemodialysis Patients” (PROHEMO) developed in Salvador, BA, Brazil. The Brazilian version of the validated CFQ-11 was used to calculate self-reported fatigue. The CFQ-11 scores may range from 0 to 33; higher scores represent more fatigue. Fatigue categories were created based on proposed cut point: absence or mild degree if CFQ-11 scores <4 and moderate to severe if scores ≥4. Cox models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) of associations between fatigue and mortality with adjustments for sociodemographic factors, time on dialysis, education, economic class, hemoglobin concentration, diabetes, heart failure, depression, and other psychiatric disorders. Results: The mean age was 51.5 ± 2.5 years, 58% were male, and 30% were diabetic. Self-reported moderate to severe fatigue was reported by 71% of patients. The mortality rate was 8.6 cases/100 person-years. Patients with moderate to severe fatigue had a more than threefold mortality rate (HR = 3.07, 95% CI: 1.19, 7.93) compared to patients with absent or mild fatigue, after extensive adjustments for covariates. Conclusion: The study provides evidence that self-reported fatigue can help identify MHD patients at higher risk of earlier death.

Hardiness and Zoom Fatigue on Nursing Students: A Cross-Sectional Study in Indonesia During Online Learning.

The Covid-19 pandemic caused a change in learning methods to online learning. Zoom fatigue is a problem that many students experience during online learning. Zoom fatigue has an impact on physical and psychological problems so that it disrupts the online learning process. Hardiness is needed by students in order to adapt to online learning. The purpose of this study was to determine the relationship between hardiness and zoom fatigue in nursing students at Universitas Padjadjaran. This study used a quantitative approach with a cross-sectional study design. The sample technique used total sampling. Respondents were 480 nursing students at Universitas Padjadjaran. The research instrument used the Zoom Exhaustion & Fatigue Scale questionnaire and the Hardiness Instrument for the Online Learning. This study shows that almost half of the respondents have a medium hardiness level category (45%) and a zoom level of medium fatigue category (46.67%). The results of the analysis show that there is a significant negative relationship between hardiness and zoom fatigue in nursing students at Universitas Padjadjaran. The higher the student's hardiness level, the lower the student's zoom fatigue level. High hardiness can increase focus during the learning process, increase student participation, and reduce stress and fatigue in students during online learning. Lecturers and students need to collaborate to improve the learning process and repeat mental health problems during online learning. This data forms the basis for university and school nurses in providing interventions for nursing students to reduce the problem of zoom fatigue.

Organic self-talk content categories and their relations to sport-specific contextual and personal factors

While strategic self-talk interventions are well documented, less is known regarding organically occurring self-talk. Previously, eight organic self-talk content categories were identified, however contextual and personal factors relating to these categories is unexplored. The aim of the study was to explore the relationships between stress, coping, athletic identity, demographic and sport-related factors and the eight organic self-talk categories of anxiety control, confidence, disengagement, instruction, psych-up, somatic fatigue, worry, and irrelevant. 216 NCAA student-athletes were recruited. Regression was used to determine the relationships between the contextual and personal variables and organic self-talk. Stress, coping and self-talk categories were compared in and out-of-season. Stress was associated with all self-talk frequencies except confidence. Coping was associated with psych-up, confidence and worry. Athletic identity was associated with psych-up, confidence, instruction and disengagement. Age was associated with anxiety control and instruction. Lastly, sport type and division level were associated with disengagement and instruction self-talk respectively.

Динамическое нормирование с использованием метода агентного моделирования процесса сборки оборудования для атомных электростанций

The work is raised as an agent-based model designed to calculate the time spent on the assembly stage of the manufacturing process for manufacturing equipment for nuclear power plants. The article focuses on the need for development, states the justification for research and development of the field of nuclear energy, with repeated facts. The paper uses various approaches to accounting for labor productivity. The concept of a gradual increase in employee fatigue for the development of the technical process is taken as the base. The agents of the model contain the workers and the technological process. The components of programs implemented in the C# language are shown, descriptions of classes are described, their actions to simulate the behavior of agents of a production system. The class diagram shows the selected classes and the relationships between them in terms of inheritance. There is a study of the use of models of a typical assembly process — the assembly of a cabinet frame, consisting of seven main operations. The paper presents structured, empirically analyzed values of fatigue categories and process time for 85 employees in graphical form by operations. It shows an example of an increase in fatigue for one of the employees and a Gantt chart, which can be used to evaluate how the operations went over time. As the output of the agent-based model, the calculated value of the time spent for the entire stage of the technological process of assembling equipment for nuclear power plants is provided. The accuracy of calculations of data convergence, income on the environment in Matlab Mathworks and Microsoft Excel during manual modeling is argued. The agreements state a slight deviation from the data model of the developed agent-based model of a practical experiment carried out as part of the implementation of the contract for the creation of equipment for a new power unit, a causal analysis is carried out. Also, in the applications, exceptional values of some performance indicators are analyzed and attention is focused on the unjustification of classical average approaches in the analysis of overall performance, using several examples. Information is given on the application of the agent model in possible options.

Factors Associated with Occupational Accidents in Construction Workers in Telaga Biru Village, Siulak District

Background: A work accident is an unwanted and unexpected event that can cause loss of time, property, or loss of life. The construction sector is an area with a fairly high risk of work accidents. Work accidents include slipping, being scratched by a sharp object, hitting the head with a heavy object, falling from a height, feet stuck with nails. Talago Biru Village is currently undergoing development development.&#x0D; Research Metodes: This research is a quantitative research using a cross sectional design. The study was conducted in Telago Biru, Siulak District, from April 18 to May 14, 2022. The sample of the research was construction workers in Telago Biru Village, Siulak District, amounting to 47 people. The sampling technique used was total sampling technique. The research instrument is a questionnaire. Data were analyzed using chi square statistical test.&#x0D; Results: As many as 61.7% of respondents had experienced work accidents, 55.3% of respondents worked with fatigue category, 46.8% of respondents worked with unfavorable actions and 46.8% of respondents worked with unfavorable working conditions. The results of the bivariate analysis showed that there was a relationship between work fatigue (p = 0.007), unsafe acts (p = 0.000) and unsafe conditions (p = 0.018) with work accidents on construction workers in Telago Biru Village, Siulak District, Kerinci Regency.&#x0D; Conclusion: Factors related to work accidents in construction workers are work fatigue, unsafe actions and unsafe conditions

Hubungan Durasi Penggunaan Media Sosial Terhadap Kejadian Asthenopia Pada Mahasiswa FKP UNRI

Introduction: The duration of using gadgets to access social media is unlimited and continuously causes the eyes to see objects on the screen. The eyes are continuously accommodated to see letters or numbers on the monitor which will result in eye fatigue (Asthenopia), research objectives: to determine the relationship between the duration of social media use and the incidence of Asthenopia in students of the Faculty of Nursing, University of Riau, materials and methods: This study using a correlational analytic design with a cross sectional approach. The study was conducted at the Faculty of Nursing, University of Riau with 237 students as samples taken by proportionate stratified random sampling technique by taking into account the inclusion and exclusion criteria. The measuring instrument used is a questionnaire. The analysis used was univariate and bivariate analysis using the Chi Square, the results of the study: The results of the bivariate statistical test showed that there was a relationship between the duration of social media use and the incidence of Asthenopia in students of the Faculty of Nursing, University of Riau with p Value (0.021) &lt; (0.05). Overall, there were 176 people (74.2%) who experienced asthenopia. On average, students experience Asthenopia in the low fatigue category due to the duration of using social media which is not good for eye health, suggestions: Students are expected to be able to control and reduce the duration of social media use in order to prevent the occurrence of Asthenopia.

Analysis of Workload, Fatigue, and Musculoskeletal Complaints among Associate Nurses at Bangli General Hospital

Introduction: Nurses experienced high physical workloads, which may increase the risk of fatigue and musculoskeletal complaints. Nurse’s workplaces, especially hospitals, have not gained serious concern and attention for this issue.&#x0D; Methods: This study was an analytic observational study with a cross sectional design aimed to analyze the workloads, fatigue, and musculoskeletal complaints among associate nurses at Bangli General Hospital, Bali. A total of 46 respondents filled out the research questionnaire given.&#x0D; Results: Based on the NASA-TLX calculations, the associate nurses’ workloads are found to be in the moderate level with the largest indicators on the PD (Physical Demand) and Performance (OP) Scale. By using the Nordic Body Map Questionnaire, most of the respondents had a low risk regarding musculoskeletal complaints and the most of musculoskeletal complaints were felt in the right and left calves, waist and back. The results of the analysis on the 30 items of self-rating test questionnaire found that most nurses experienced fatigue in a low category (57.45%) and only a small percentage of nurses experienced high fatigue category (8.51%).&#x0D; Conclusion: Workloads, fatigue, and musculoskeletal complaints need further investigations to get better understanding of the cause in order to get better solutions.

Synthetic SN Curve of Steel Beams with Web Opening

Steel beams with web opening have become a popular structural element nowadays owing to their several structural and architectural benefits. This study numerically investigates a study of the behavior of steel beams with a web opening subjected to fatigue loading using the finite element software ANSYS. Simply supported I-section steel beams with a single web opening were studied under a fully reversed, uniformly distributed vertical load. Fatigue loading, material properties, and boundary conditions are discussed in detail. Finite element analysis was used to determine the effect of the web opening on the normal stress induced in the steel beam and consequently on fatigue stress life. Then, a parametric study was performed to investigate the effect of two geometric parameters (opening size alpha and opening location beta ). In addition, suitable fatigue categories were suggested to guarantee safety against fatigue failures. Further, an analytical method for predicting the synthetic SN curves for steel beams with web opening was introduced. The proposed method was validated using SN curves obtained from FE results and was proven safe and slightly conservative for steel beams with a single web opening of various sizes and locations, as well as spans.

Magnetic Barkhausen Noise Technique for Fatigue Detection and Classification in Martensitic Stainless-Steel

Abstract Stainless steel is used in many applications because of its excellent mechanical properties at elevated temperatures. Material fatigue is a major problem in steel structures and can cause catastrophic damage resulting in significant economic consequences. Conventional nondestructive evaluation techniques can detect macro defects but do not perform well when it comes to material degradation due to fatigue, which happens at a microstructure level. It is well known that stress applied on a material will have an impact on the microstructure and produces a change in the magnetic properties of the material. Hence, magnetic nondestructive evaluation techniques that are sensitive to changes in magnetic properties play a major role in the early-stage fatigue detection, i.e., before the macro crack initiates. This paper introduces the magnetic Barkhausen noise technique to garner information about fatigue state of the material under test. K-medoids clustering algorithm and genetic optimization algorithm are used to classify the stainless-samples into fatigue categories. The results prove that martensitic grade stainless-steel samples in different stages of fatigue can be classified into broad fatigue categories, i.e., low fatigue, mid fatigue, and high fatigue based on the remaining useful life of the sample.

Faktor Yang Berhubungan dengan Kecelakaan Kerja Pada Pekerja Bangunan di Desa Telago Biru Kecamatan Siulak

A work accident is an unwanted and unexpected event that can cause loss of time, property, or loss of life. The construction sector is an area with a fairly high risk of work accidents. Work accidents include slipping, being scratched by a sharp object, hitting the head with a heavy object, falling from a height, feet stuck with nails. Talago Biru Village is currently undergoing development development. The purpose of this study was to determine the factors associated with work accidents on construction workers in Telago Biru Village, Siulak District, Kerinci Regency. This research is a quantitative research using a cross sectional design. The study was conducted in Telago Biru, Siulak District, from April 18 to May 14, 2022. The sample of the research was construction workers in Telago Biru Village, Siulak District, amounting to 47 people. The sampling technique used was total sampling technique. The research instrument is a questionnaire. Data were analyzed using chi square statistical test. As many as 61.7% of respondents had experienced work accidents, 55.3% of respondents worked with fatigue category, 46.8% of respondents worked with unfavorable actions and 46.8% of respondents worked with unfavorable working conditions. The results of the bivariate analysis showed that there was a relationship between work fatigue (p = 0.007), unsafe acts (p = 0.000) and unsafe conditions (p = 0.018) with work accidents on construction workers in Telago Biru Village, Siulak District, Kerinci Regency.

A unified evaluation method for fatigue resistance of riveted joints based on structural stress approach

Many riveted steel bridges were constructed worldwide between 1850 and 1950. A number of them are still in operation, and their fatigue damage is a major burden in maintenance. This paper presents a unified structural stress approach to evaluate the fatigue resistance of riveted joints for steel bridges. The presented approach was utilized to establish and calibrate S-N curves for riveted joints based on fatigue data from 114 tested specimens, and the curves were validated by fatigue test data from large-scale riveted structures. A single fatigue category was obtained to evaluate different types and sizes of riveted structures. The investigation results showed that the presented approach is capable of evaluating different types of riveted joints and structural stresses. The structural stress approach is insensitive to the mesh size and the element type in finite element analysis. The presented method is convenient for practical engineers to evaluate the fatigue resistance and fatigue life of riveted steel bridges.

The Effect of Subjective Fatigue on Auditory Processing in Musicians and Nonmusicians

We assessed fatigue's effect on temporal resolution and speech perception in noise abilities in trained instrumental musicians. In a pretest-posttest quasiexperimental research design, trained instrumental musicians (n = 39) and theater artists as nonmusicians (n = 37) participated. Fatigue was measured using a visual analog scale (VAS) under eight fatigue categories. The temporal release of masking measured the temporal resolution, and auditory stream segregation assessed speech perception in noise. Entire testing was carried out at two time-points: before and after rehearsal. Each participant rehearsed for five to six hours: musicians playing musical instruments and theater artists conducted stage practice. The results revealed significantly lower VAS scores for both musicians and nonmusicians after rehearsal, indicating that both musicians and nonmusicians were fatigued after rehearsal. The musicians had higher scores for temporal release of masking and lower scores for auditory stream segregation abilities than nonmusicians in the pre-fatigue condition, indicating musicians’ edge in auditory processing abilities. However, no such differences in the scores of musicians and nonmusicians were observed in the post-fatigue testing. The results were inferred as the music training related advantage in temporal resolution, and speech perception in noise might have been reduced due to fatigue. In the end, we recommend that musicians consider fatigue a significant factor, as it might affect their performance in auditory processing tasks. Future researchers must also consider fatigue as a variable while measuring auditory processing in musicians. However, we restricted the auditory processing to temporal resolution and speech perception in noise only. Generalizing these results to other auditory processes requires further investigation.

In Vivo Feasibility Test of a New Flexible Ureteroscopic Robotic System, easyUretero, for Renal Stone Retrieval in a Porcine Model.

Using a new robotic endoscopic platform system developed for retrograde intrarenal surgery (RIRS) called easyUretero (ROEN Surgical Inc.), we evaluated the feasibility and safety of renal stone retrieval in a porcine model. Six female pigs were used for our in vivo study. First, 0.3-cm-sized phantom stones were inserted into the kidneys of each pig via the ureteral access sheath. Next, renal stone retrieval was attempted using manual RIRS in three pigs and robotic RIRS in three pigs. Three surgeons performed extraction of 10 stones in each session. The mean stone retrieval time by manual RIRS was significantly shorter than that by robotic RIRS (399.9±185.4 sec vs. 1127.6±374.5 sec, p=0.001). In contrast, the questionnaire regarding usability showed high satisfaction in the surgeons' fatigue category for surgeons using robotic RIRS. The radiation exposure dose was also lower in robotic RIRS than in manual RIRS (0.14 µSv vs. 45.5 µSv). Postoperative ureteral injury assessment revealed Grade 0 in manual RIRS cases and Grades 0, 1, and 2 in robotic RIRS cases. The easyUretero system is a new robotic RIRS system that was developed in Korea. The results of the present study suggest that using easyUretero for stone retrieval during RIRS is safe and ergonomic.

Gambaran Rerata Kelelahan pada Pasien Kanker yang Menjalani Kemoterapi

This study aims to determine the average fatigue score in cancer patients undergoing chemotherapy treatment at RSUP. Dr. M. Djamil Padang. The type of research used is descriptive quantitative. The results of this study indicate that the average value of the respondent's level of fatigue is 28.78, with a minimum value of 19 and a maximum of 37 using 95% CI. If categorized as 66.6% of respondents experienced moderate fatigue, and as many as 33.4% experienced severe fatigue. In conclusion, the average value of the respondents' fatigue level mainly was in the intermediate fatigue category, and almost half of them were extreme fatigue.&#x0D; &#x0D; Keywords: Cancer, Fatigue, Chemotherapy

Sex differences in the impact of state and trait fatigue on gait variability.

123 healthy adults (77 female, 46 male), aged 18-36years, completed the Mental and Physical State and Trait Energy and Fatigue Scale. Using a median split for each fatigue variable, participants were placed into "low" or "high" fatigue categories. Gait variability was defined as the asymmetry of lateral step variability (ALSV) and coefficient of variation (CV) of gait speed, stride length and double limb (DL) support during overground walking. Males with low state PF had greater ALSV than females with low state PF (p=0.05, η2p=0.07) and males with high state PF (p=0.007, η2p=0.15). Females with high trait MF had greater CV of gait speed than females with low trait mental fatigue (p=0.02, η2p=0.08). Males with low trait MF had greater CV of gait speed (p=0.01, η2p=0.10) and stride length (p=0.002, η2p=0.17) than females with low trait MF. CV of DL support did not vary based on fatigue level or sex (p≥0.11). There are sex-specific differences in the impact of state PF on asymmetry of lateral step variability and trait MF on the variability of gait speed and stride length.

Prevalence and burden of multiple sclerosis-related fatigue: a systematic literature review

BackgroundMultiple sclerosis (MS) is a chronic, demyelinating disease of the central nervous system that results in progressive and irreversible disability. Fatigue is one of the most common MS-related symptoms and is characterized by a persistent lack of energy that impairs daily functioning. The burden of MS-related fatigue is complex and multidimensional, and to our knowledge, no systematic literature review has been conducted on this subject. The purpose of this study was to conduct a systematic literature review on the epidemiology and burden of fatigue in people with multiple sclerosis (pwMS).MethodsSystematic searches were conducted in MEDLINE, Embase, and Evidence-Based Medicine Reviews to identify relevant studies of fatigue in pwMS. English-language records published from 2010 to January 2020 that met predefined eligibility criteria were included. We initially selected studies that reported quality of life (QoL) and economic outcomes according to categories of fatigue (e.g., fatigued vs non-fatigued). Studies assessing associations between economic outcomes and fatigue as a continuous measure were later included to supplement the available data.ResultsThe search identified 8147 unique records, 54 of which met the inclusion criteria. Of these, 39 reported epidemiological outcomes, 11 reported QoL, and 9 reported economic outcomes. The supplementary screen for economic studies with fatigue as a continuous measure included an additional 20 records.Fatigue prevalence in pwMS ranged from 36.5 to 78.0%. MS-related fatigue was consistently associated with significantly lower QoL. Results on the economic impact of fatigue were heterogeneous, but most studies reported a significant association between presence or severity of fatigue and employment status, capacity to work, and sick leave. There was a gap in evidence regarding the direct costs of MS-related fatigue and the burden experienced by caregivers of pwMS.ConclusionFatigue is a prevalent symptom in pwMS and is associated with considerable QoL and economic burden. There are gaps in the evidence related to the direct costs of MS-related fatigue and the burden of fatigue on caregivers. Addressing fatigue over the clinical course of the disease may improve health and economic outcomes for patients with MS.