Fatigue in neuromuscular disorders: focus on Guillain–Barré syndrome and Pompe disease

Fatigue accounts for an important part of the burden experienced by patients with neuromuscular disorders. Substantial high prevalence rates of fatigue are reported in a wide range of neuromuscular disorders, such as Guillain–Barré syndrome and Pompe disease. Fatigue can be subdivided into experienced fatigue and physiological fatigue. Physiological fatigue in turn can be of central or peripheral origin. Peripheral fatigue is an important contributor to fatigue in neuromuscular disorders, but in reaction to neuromuscular disease fatigue of central origin can be an important protective mechanism to restrict further damage. In most cases, severity of fatigue seems to be related with disease severity, possibly with the exception of fatigue occurring in a monophasic disorder like Guillain–Barré syndrome. Treatment of fatigue in neuromuscular disease starts with symptomatic treatment of the underlying disease. When symptoms of fatigue persist, non-pharmacological interventions, such as exercise and cognitive behavioral therapy, can be initiated

The impact of regular physical activity on fatigue, depression and quality of life in persons with multiple sclerosis

<p>Abstract</p> <p>Background</p> <p>The purpose of this study was to compare fatigue, depression and quality of life scores in persons with multiple sclerosis who do (Exercisers) and do not (Non-exercisers) regularly participate in physical activity.</p> <p>Methods</p> <p>A cross-sectional questionnaire study of 121 patients with MS (age 25–65 yr) living in Queensland, Australia was conducted. Physical activity level, depression, fatigue and quality of life were assessed using the International Physical Activity Questionnaire, Health Status Questionnaire Short Form 36, Becks Depression Inventory and Modified Fatigue Impact Scale.</p> <p>Results</p> <p>52 participants performed at least two 30-min exercise sessions·wk^-1(Exercisers) and 69 did not participate in regular physical activity (Non-exercisers). Exercisers reported favourable fatigue, depression and quality of life scores when compared to Non-exercisers. Significant weak correlations were found between both leisure-time and overall reported physical activity levels and some subscales of the quality of life and fatigue questionnaires. Additionally, some quality of life subscale scores indicated that regular physical activity had a greater benefit in subjects with moderate MS.</p> <p>Conclusion</p> <p>Favourable fatigue, depression and quality of life scores were reported by persons with MS who regularly participated in physical activity, when compared to persons with MS who were classified as Non-exercisers.</p

The effect of varying degrees of compression from elastic vs plastic wrap on quadriceps intramuscular temperature during wetted ice application

The aim of this study was to evaluate and compare the effectiveness of wetted ice bag, applied with high compression elastic wrap or held in place with low compression plastic wrap, on reducing vastus lateralis intramuscular temperature and skin surface temperature. Ten healthy male participants had wetted ice packs applied to a standardized area on the anterior aspect of the quadriceps simultaneously to both legs for 30 minutes. The ice pack was secured with high compression (elastic wrap) to the left anterior thigh (60.6 ± 8.1 mm Hg) and low compression (plastic wrap) to the right anterior thigh (15.5 ± 4.0 mm Hg). Intramuscular temperature (1 and 3 cm) and skin temperature of the vastus lateralis were measured continuously during a 10‐minute baseline period, 30‐minute treatment period, and a 60‐minute recovery period. No difference was observed between treatments in terms of the magnitude of reduction in intramuscular temperature at both 1 cm and 3 cm and skin temperature regardless of compression pressure (P > .05). Temperature upon conclusion of elastic wrap treatment was: 17.8 ± 5.2°C at 1 cm, 23.1 ± 4.9°C at 3 cm; plastic wrap treatment: 17.9 ± 4.4°C at 1 cm, 24.5 ± 6.7°C at 3 cm. Plastic wraps may offer a practical alternative to elastic wraps for clinicians as they may be disposed of by the patient or athlete without having to stay at the treatment facility