Fatigue-Related Changes of Daily Function: Most Promising Measures for the Digital Age, 2024, Maetzler

https://karger.com/dib/article/8/1/30/896874

REVIEW ARTICLES| MARCH 20 2024
Fatigue-Related Changes of Daily Function: Most Promising Measures for the Digital Age


Subject Area: Further Areas , General Medicine , Public Health
https://doi.org/10.1159/000536568
38510264

Walter Maetzler;

Leonor Correia Guedes;

Kirsten Nele Emmert;

Jennifer Kudelka;

Hanna Luise Hildesheim;

Emma Paulides;

Hayley Connolly;

Kristen Davies;

Valentina Dilda;

Teemu Ahmaniemi;

Luisa Avedano;

Raquel Bouça-Machado;

Michael Chambers;

Meenakshi Chatterjee;

Peter Gallagher;

Johanna Graeber;

Corina Maetzler;

Hanna Kaduszkiewicz;

Norelee Kennedy;

Victoria Macrae;

Laura Carrasco Marín;

Anusha Moses;

Alessandro Padovani;

Andrea Pilotto;

Natasha Ratcliffe;

Ralf Reilmann;

Madalena Rosario;

Stefan Schreiber;

Dina De Sousa;

Geert Van Gassen;

Lori Ann Warring;

Klaus Seppi;

C. Janneke van der Woude;

Joaquim J. Ferreira;

Wan-Fai Ng;

on behalf of the IDEA-FAST project consortium

Background:

Fatigue is a prominent symptom in many diseases and is strongly associated with impaired daily function. The measurement of daily function is currently almost always done with questionnaires, which are subjective and imprecise. With the recent advances of digital wearable technologies, novel approaches to evaluate daily function quantitatively and objectively in real-life conditions are increasingly possible. This also creates new possibilities to measure fatigue-related changes of daily function using such technologies.

Summary:

This review examines which digitally assessable parameters in immune-mediated inflammatory and neurodegenerative diseases may have the greatest potential to reflect fatigue-related changes of daily function.

Key Messages:

Results of a standardized analysis of the literature reporting about perception-, capacity-, and performance-evaluating assessment tools indicate that changes of the following parameters: physical activity, independence of daily living, social participation, working life, mental status, cognitive and aerobic capacity, and supervised and unsupervised mobility performance have the highest potential to reflect fatigue-related changes of daily function. These parameters thus hold the greatest potential for quantitatively measuring fatigue in representative diseases in real-life conditions, e.g., with digital wearable technologies. Furthermore, to the best of our knowledge, this is a new approach to analysing evidence for the design of performance-based digital assessment protocols in human research, which may stimulate further systematic research in this area.

Keywords:

• Activities of daily life, International Classification of Functioning, disability and health, Performance, Wearables

 

It would be more helpful if the diseases which have a symptom of fatigue (wouldn't that be most of them?) were investigated rather than fiddling about trying to "fix" a single symptom of fatigue.

It feels a bit like people trying to fix the fatigue associated with anaemia rather than fixing the anaemia. In my experience doctors often sidestep the actual problem by prescribing anti-depressants.

 

Glad to hear people thinking along the same lines. I was struck by the 2024 CDC multi-site study that showed the time spent vertically/horizontally in 15 hr span. That's exactly what I've been doing for fatigue measure and I measured 7-8 hrs spent lying down, the exact average in the study, back in 2015. Now I'm spending 2 hrs on good days and 5 hrs when I'm struggling. They should use that as a fatigue measure more often.

The consumer grade wearables lack accuracy though. I've been using minute-by-minute measure of calorie expenditure on my Fitbit for exertion, but it doesn't work for short bursts of high intensity activities, like walking up a flight of stairs or squatting, which ME/CFS patients are highly sensitive to. It can't predict certain PEM as result. It would be great if it can discern ADL activities and motions, like it already does for certain exercise activities like running or biking. Then we could use MET values for those activities/motions rather than calorie data for more accurate assessment.