Fatigue and correlation with disease-specific variables, spinal mobility measures, and health-related quality of life in
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ORIGINAL ARTICLE
Fatigue and correlation with disease-specific variables, spinal mobility measures, and health-related quality of life in ankylosing spondylitis Berat Meryem Alkan • Fatma Fidan • S¸ u¨kran Erten • Hatice Aksekili • Ays¸ enur Alemdar ¨ zge Ardıc¸og˘lu • Aliye Tosun Esra Erog˘lu • O
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Received: 30 August 2012 / Accepted: 8 November 2012 / Published online: 8 December 2012 Ó Japan College of Rheumatology 2012
Abstract Objectives This study aimed to evaluate fatigue in Turkish patients with ankylosing spondylitis (AS) and its relationship with disease-specific variables, spinal mobility measures, and health-related quality of life (HR-QoL). Methods One hundred and ten patients diagnosed as AS according to the Modified New York Criteria and 40 healthy individuals were included in this study. The Multidimensional Assessment of Fatigue (MAF) was used in patient and control groups to assess fatigue. The first item of Bath AS Disease Activity Index (BASDAI) was also used to assess fatigue in the patient group. Evaluation included BASDAI, functional status [BAS Functional Index (BASFI)], and visual analog scale (VAS) of axial and joint pain. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were also measured. The generic instrument Short Form 36 (SF 36) was used to assess HRQoL in the patient group. Results Patients with AS had higher total MAF scores and in all MAF subgroup scales than controls. All patient MAF scores were significantly correlated with morning stiffness, number of swollen joints, history of peripheral arthritis, BASDAI, BASFI, BASDAI-fatigue, VAS axial, VAS peripheral, and SF 36 subgroups (p \ 0.05). No correlation was observed between all MAF scores and age, body mass index (BMI), disease duration, meteorological measures, and medications in patients. Conclusions Patients with AS defined significantly more fatigue when compared with healthy persons. MAF was
B. M. Alkan (&) F. Fidan S¸ . Erten H. Aksekili ¨ . Ardıc¸og˘lu A. Tosun A. Alemdar E. Erog˘lu O Atatu¨rk Education and Research Hospital Ankara, Ahmet Taner Kıs¸ lalı mah. 2875 sok no 8, C¸ayyolu, Ankara, Turkey e-mail: [email protected]
related to clinical and functional status and HR-QoL of patients with AS. We assume that MAF can be used as a sensitive fatigue measure in patients with AS. Keywords Ankylosing spondylitis MAF Metrological measures HR-QoL
Introduction Ankylosing spondylitis (AS) is a chronic inflammatory rheumatic disease that affects the axial skeleton and often peripheral joints. AS is associated with functional limitations as determined by impairment of activities of daily living (ADL) and diminished quality of life (QoL) [1, 2]. Fatigue has been shown as a major symptom impacting patient’s health-related QoL (HR-QoL) [3, 4]. Likewise, fatigue is now considered a core symptom that greatly affects life in patients with AS [4, 5]. Therefore, evaluation of fatigue in AS patients is important. The Multidimensional Assessment of Fatigue scale (MAF) was originally developed t
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