Fatigue Severity Scale

 

Original Editor - Sinead Greenan

Top Contributors - Sinead Greenan, Laura Ritchie, Evan Thomas and Claire Knott

Objective

The Fatigue Severity Scale is a 9-item scale which measures the severity of fatigue and its effect on a person's activities and lifestyle in patients with a variety of disorders

Intended Population

Those with a variety of diagnoses including arthritis, fibromyalgia, multiple sclerosis, Parkinson’s disease and stroke.

Method of Use

  • A 9-item questionnaire with questions related to how fatigue interferes with certain activities and rates its severity
  • The items are scored on a 7 point scale with 1 = strongly disagree and 7= strongly agree
  • The minimum score = 9 and maximum score possible = 63. Higher the score = greater fatigue severity
  • Another way of scoring: mean of all the scores with minimum score being 1 and maximum score being 7
  • Self-report scale

Evidence

Reliability

Test-retest Reliability

Parkinson's Disease:

(Valderramas et al, 2012; n = 30, mean age = 62 (11) years, mean time post- PD = 7.6 (6.5) years) [1]

  • The evaluation of the FSS-BR (Fatigue Severity Scale-Brazilian-Portuguese version) suggests an excellent Test-retest reliability (ICC = 0.91)

Interrater/Intrarater Reliability

Not established

Validity

Criterion Validity (Predictive/Concurrent)

Not established

Construct Validity (Convergent/Discriminant)

Convergent Validity:

Parkinson’s Disease:

  • Excellent (r = -0.77) negative correlation with Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) scale (Hagell et al, 2006) [2]
  • Excellent (r = 0.62) correlation with Nottingham Health Profile (NHP-EN) scale (Hagell et al, 2006) 
  • Excellent (r = 0.84) correlation with Parkinson’s Fatigue (PFS) scale (Grace et al, 2006) [3]
  • Poor-adequate (r = 0.22-0.47) correlation with Parkinson’s Disease Questionnaire-39 (PDQ-39) scale (Herlofson et al, 2003; n = 66, mean age = 70.8 (9.9) years, time since PD = 70.2 (56.1) months) [4]

Responsiveness

Parkinson’s Disease:

Responsiveness to Pharmocological Intervention Mendoca et al, 2007; n = 17 treatment arm, receiving methyphenidate; mean age = 62.2(10), mean H&Y Stage = 2.58(0.5); n = 19 placebo arm, mean age = 66.3(7.6), mean H&Y Stage = 2.38(0.3) 

  • Those persons in the treatment arm had a significant (p < 0.04) reduction in FSS Score by 6.5 points (from FSS = 43.8 at baseline); Cohen’s d = 0.79
  • Smaller reductions in the placebo group did not reach levels of significance Response to Exercise Intervention: Winward et al, 2010; H&Y 0-4. n = 20 exercise group, mean age = 63.4(6.7); n = 19 control group, mean age = 64.9(9.6)
  • No significant difference in score reduction between exercise and control group at 12 weeks

Links

Fatigue Severity Scale

References

  1. Valderramas, S., Feres, A. C., et al. "Reliability and validity study of a Brazilian-Portuguese version of the fatigue severity scale in Parkinson's disease patients." Arq Neuropsiquiatr 2012 70(7): 497-500
  2. Hagell, P., Hoglund, A., et al. "Measuring fatigue in Parkinson's disease: a psychometric study of two brief generic fatigue questionnaires." J Pain Symptom Manage 2006 32(5): 420-432
  3. Grace, J., Mendelsohn, A., et al. "A comparison of fatigue measures in Parkinson's disease." Parkinsonism Relat Disord 2007 13(7): 443-445
  4. Herlofson, K. and Larsen, J. P. "The influence of fatigue on health-related quality of life in patients with Parkinson's disease." Acta Neurol Scand 2003 107(1): 1-6