Clinical manifestation and perceived symptoms of walking-related performance fatigability in persons with multiple sclerosis

F. Van Geel*, H. Bielen, K. Theunissen, L. Moumdjian, J. Van Nieuwenhoven, B. Van Wijmeersch, R. Meesen, C. Ramari, P. Feys

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Fatigue and walking difficulties are common impairments and activity limitations in persons with multiple sclerosis (PwMS). Walking fatigability (WF) can be measured by a Distance Walked Index and is defined as a decline in walking distance of 10% or more during the six-minute walking test (6MWT). However, the clinical manifestation and perceived symptoms related to fatigability are still not well documented. Forty-nine PwMS [Expanded Disability Status Scale (EDSS) <= 6] and 28 healthy controls (HC) performed a 6MWT. The perceived severity of 11 common symptoms was rated on a visual analogue scale of 0-10 before, immediately after, and 10, 20 and 30 minutes after the 6MWT by means of the symptom inventory. Short motor impairment screening tests at baseline together with other descriptive measures were performed. Twenty pwMS were categorized in the WF group and were more disabled (EDSS: 4.16 +/- 1.41) than the non-walking fatigability group (n = 29, EDSS: 2.62 +/- 1.94). PwMS showed exacerbations of several perceived symptoms in MS, where most symptoms returned to baseline within 10 minutes after the walking test. The WF group showed significantly more muscle weakness and gait impairment, together with balance problems, and experienced an increase in spasticity, pain and dizziness after 6MWT. Our findings showed that perceived severity of symptoms are higher in pwMS presenting WF, and increase temporally after the 6MWT. Future research with quantitative measurement during and after walking is recommended.
Original languageEnglish
Pages (from-to)118-125
Number of pages8
JournalInternational Journal of Rehabilitation Research
Issue number2
Publication statusPublished - 1 Jun 2021


  • clinical
  • fatigability
  • manifestation
  • multiple sclerosis
  • walking


Dive into the research topics of 'Clinical manifestation and perceived symptoms of walking-related performance fatigability in persons with multiple sclerosis'. Together they form a unique fingerprint.

Cite this