Article

Persons with multiple sclerosis (PwMS) are often characterized by
increased motor fatigability, which is a performance change on an objectively
measured criterion after any type of voluntary muscle contractions. This review
summarizes the existing literature to determine which protocols and outcome
measures are best to detect or study motor fatigability and the underlying
mechanisms in MS. METHODS: Two electronic databases, PubMed and Web of Science,
were searched for relevant articles published until August 2016 with a
combination of multiple sclerosis, fatigability, muscle fatigue, and motor
fatigue. RESULTS: A total of 48 articles were retained for data extraction. A
variety of fatigability protocols were reported; protocols showed differences in
type (isometric vs concentric), duration (15 to 180 s), and number of
contractions (fixed or until exhaustion). Also, 12 articles reported motor
fatigability during functional movements, predominantly assessed by changes in
walking speed; 11 studies evaluated the mechanisms underlying motor fatigability,
using additional electrical nerve or transcranial magnetic stimulation. Three
articles reported psychometrics of the outcomes.
CONCLUSIONS: The disparity of
protocols and outcome measures to study different aspects of motor fatigability
in PwMS impedes direct comparison between data.
Most protocols use maximal
single-joint isometric contractions, with the advantage of high standardization.
Because there is no head-to-head comparison of the different protocols and only
limited information on psychometric properties of outcomes, there is currently no
gold standard to assess motor fatigability. The disability level, disease phenotype, and studied limb may influence the assessment of motor fatigability in
PwMS.

Langue : ANGLAIS