Fatigue Severity Scale

 

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

[1]

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) [2]

  • 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) [3]
  • 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) [4]
  • 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) [5]

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

References

  1. Mometrix Academy. Fatigue severity scale. Available from: https://www.youtube.com/watch?v=XAwDgczNCO0 )last accessed 3.3.2019)
  2. 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
  3. 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
  4. Grace, J., Mendelsohn, A., et al. "A comparison of fatigue measures in Parkinson's disease." Parkinsonism Relat Disord 2007 13(7): 443-445
  5. 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