Epub: Hebert & Corboy. The association between multiple sclerosis-related fatigue and balance as a function of central sensory integration. Gait Posture. 2012 Nov
OBJECTIVE: To examine the relationship between symptomatic fatigue and balance as a function of central sensory integration in MSers.
MATERIALS AND METHODS: Seventeen RRMSers were enrolled in this cross-sectional study. Primary measurements included fatigue (modified fatigue impact scale – MFIS); balance (dynamic posturography, sensory organization testing – SOT); and walking capacity (six-minute walk test – 6MWT).
RESULTS: Fatigue scores were significantly associated with balance: MFIS total (r=-0.78; p<0.001), physical subscale (r=-0.77; p<0.001), cognitive subscale (r=-0.75; p=0.001) and psychosocial subscale (r=-0.53; p=0.030) scores. MFIS total score was a significant predictor of balance (p≤0.001), accounting for 62% of the variability in SOT composite scores. Significant differences in fatigue (d=1.75; p=0.005) and balance (d=1.74; p=0.005) were found for participants who had cerebellar and brainstem involvement compared to those without.
CONCLUSIONS: Symptomatic fatigue is significantly related to balance and is a significant predictor of balance as a function of central sensory integration in MSers. Fatigue and balance are associated with cerebellar and brainstem involvement. This study provides early evidence supporting the theory that for those MSers who struggle to maintain steady balance during tasks that stimulate the central sensory integration process, complaints of significant levels of fatigue are probable.
“Interesting that poor balance is related to fatigue. I assume the process of concentrating on not falling consumes energy and exacerbates fatigues. This is something that never occurred to me. I wonder if fatigue improves when MSers with poor balance start using a wheelchair; does their fatigue improve?”
Does fatigue improve with wheelchair use? Speaking for myself, it seems not.
MS fatigue is, unfortunately, only helped on the margin by sitting down. Fatigue remains even after a full night’s sleep, though it too helps on the margin. Unfortunately, sufferers of chronic fatigue also suffer from interrupted sleep so the problem is compounded. MS fatigue is, in the end, not largely an exertion-induced problem. It may be mitochrondial in origin and expression, with the role of the nervous system in question. I can best describe MS fatigue as similar to the one felt after something like the flu or a cold has run its early course, but from which one is still not fully restored. So maybe the fatigue has an infectious factor as its agent. I suspect that if the mystery of MS fatigue were solved, one might find greater clues as to the nature of MS in general.
It is somewhat less fatiguing but only in a similar way as if you had undertaken a triathlon and then didn't have to walk around with an ice skate on one foot and a toothpick strapped to the bottom of the other for the rest of the day.Multi-tasking is fatiguing – and almost everything involves a whole lot of multiple tasks. Seems to me, it is because tasks that previously were done at a sub-conscious kind of level now have to be done at a very conscious deliberate level. So it is the concentrating rather than specifically what is being concentrated on – if you are vertical then by default balance consumes a lot of that concentration. :))
In my wife's case fatique disappeared in summer 2010, after CCSVI angioplasty. Before that fatique was one of her worst symptoms, and she was quite often just resting in bed, or she couldnt keep her eyes open, so tired. I understood that MS fatique was quite different from normal tiredness. Her energy levels have been normal now for long time, and can even exercise hard, which was not possible couple of years before operation. There are some pilot studies that connect CCSVI and fatique. This is very important area of research. Fatique is just horrible.
Fatigue and poor balance could be linked if they were both caused by another factor (such as ccsvi).