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- Title
Physical Fatigue, Fitness, and Muscle Function in Patients With Antineutrophil Cytoplasmic Antibody-Associated Vasculitis.
- Authors
McClean, Andrew; Morgan, Matthew D.; Basu, Neil; Bosch, Jos A.; Nightingale, Peter; Jones, David; Harper, Lorraine
- Abstract
<bold>Objective: </bold>This study investigated differences in cardiorespiratory fitness, muscular function, perceived exertion, and anxiety/depression between patients and healthy controls (HCs) and assessed which of these variables may account for the fatigue experienced by patients.<bold>Methods: </bold>Fatigue was measured in 48 antineutrophil cytoplasmic antibody-associated vasculitis patients and 41 healthy controls using the Multidimensional Fatigue Inventory (MFI-20), focusing on the physical component. Quality of life, anxiety/depression, and sleep quality were assessed by validated questionnaires. Muscle mass was measured by dual-energy x-ray absorptiometry scan, strength as the maximal voluntary contraction (MVC) force, and endurance as sustained isometric contraction at 50% MVC of the quadriceps. Voluntary activation was assessed by superimposed electrical stimulation. Cardiorespiratory fitness ( ˙Vo2 max and oxygen pulse [O2 pulse]) and perceived exertion (Borg scale) were measured during progressive submaximal exercise.<bold>Results: </bold>Patients reported elevated physical fatigue scores compared to HCs (patients MFI-20 physical 13 [interquartile range (IQR) 8-16], HCs MFI-20 physical 5.5 [IQR 4-8]; P < 0.001). Muscle mass was the same in both groups, but MVC and time to failure in the endurance test were lower due to reduced voluntary activation in patients. Estimated ˙Vo2 max and O2 pulse were the same in both groups. For the same relative workload, patients reported higher ratings of perceived exertion, which correlated with reports of MFI-20 physical fatigue (R(2) = 0.2). Depression (R(2) = 0.6), anxiety (R(2) = 0.3), and sleep disturbance (R(2) = 0.3) were all correlated with MFI-20 physical fatigue.<bold>Conclusion: </bold>These observations suggest that fatigue in patients is of a central rather than peripheral origin, supported by associations of fatigue with heightened perception of exertion, depression, anxiety, and sleep disturbance but normal muscle and cardiorespiratory function.
- Subjects
ANXIETY; AUTOIMMUNE diseases; MENTAL depression; FATIGUE (Physiology); MUSCLE strength; PHYSICAL fitness; QUALITY of life; SKELETAL muscle; MUSCLE fatigue; DISEASE complications; PSYCHOLOGY
- Publication
Arthritis Care & Research, 2016, Vol 68, Issue 9, p1332
- ISSN
2151-464X
- Publication type
journal article
- DOI
10.1002/acr.22827