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Fatigue in neuromuscular disorders: focus on Guillain-Barré syndrome and Pompe disease.

de Vries JM, Hagemans ML, Bussmann JB, van der Ploeg AT, van Doorn PA - Cell. Mol. Life Sci. (2010)

Bottom Line: Substantial high prevalence rates of fatigue are reported in a wide range of neuromuscular disorders, such as Guillain-Barré syndrome and Pompe disease.Treatment of fatigue in neuromuscular disease starts with symptomatic treatment of the underlying disease.When symptoms of fatigue persist, non-pharmacological interventions, such as exercise and cognitive behavioral therapy, can be initiated.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, Erasmus MC, University Medical Centre, Room Number EE 22-30, Dr. Molenwaterplein 50-60, Postbus 2040, 3000 CA Rotterdam, The Netherlands. j.m.devries@erasmusmc.nl

ABSTRACT
Fatigue accounts for an important part of the burden experienced by patients with neuromuscular disorders. Substantial high prevalence rates of fatigue are reported in a wide range of neuromuscular disorders, such as Guillain-Barré syndrome and Pompe disease. Fatigue can be subdivided into experienced fatigue and physiological fatigue. Physiological fatigue in turn can be of central or peripheral origin. Peripheral fatigue is an important contributor to fatigue in neuromuscular disorders, but in reaction to neuromuscular disease fatigue of central origin can be an important protective mechanism to restrict further damage. In most cases, severity of fatigue seems to be related with disease severity, possibly with the exception of fatigue occurring in a monophasic disorder like Guillain-Barré syndrome. Treatment of fatigue in neuromuscular disease starts with symptomatic treatment of the underlying disease. When symptoms of fatigue persist, non-pharmacological interventions, such as exercise and cognitive behavioral therapy, can be initiated.

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Related in: MedlinePlus

Fatigue as a multidimensional concept implemented in the World Health Organization’s Classification of Functioning, Disability, and Health. The multidimensional concept of fatigue is integrated in the World Health Organization’s International Classification of Functioning, Disability and Health (WHO-ICF), representing the effect of disease on body function and structure, activity and participation of the patient [1]. Both experienced fatigue and physiological fatigue have an effect on activity and participation and are in most diseases related to health status and disease severity. Psychosocial factors have an influence on fatigue and on activity and participation. The numbers indicate at which level the different treatment strategies have an effect on fatigue: I treatment of underlying disease; II rehabilitation and exercise; III pharmacotherapeutics; IV cognitive behavior therapy
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Fig1: Fatigue as a multidimensional concept implemented in the World Health Organization’s Classification of Functioning, Disability, and Health. The multidimensional concept of fatigue is integrated in the World Health Organization’s International Classification of Functioning, Disability and Health (WHO-ICF), representing the effect of disease on body function and structure, activity and participation of the patient [1]. Both experienced fatigue and physiological fatigue have an effect on activity and participation and are in most diseases related to health status and disease severity. Psychosocial factors have an influence on fatigue and on activity and participation. The numbers indicate at which level the different treatment strategies have an effect on fatigue: I treatment of underlying disease; II rehabilitation and exercise; III pharmacotherapeutics; IV cognitive behavior therapy

Mentions: Fatigue covers a broad spectrum of symptoms and complaints, and has no uniform definition. In clinical research, commonly used definitions of fatigue are an overwhelming and persistent feeling of tiredness and diminished ability to sustain voluntary mental and physical activities. In addition, weakness, lethargy and lack of energy that interfere with daily activities are used as definitions [9, 13, 22, 23, 29, 51, 53, 57, 107]. In basic neurosciences, it is defined as a time-related force decline [32, 102]. Considering the different aspects of fatigue it is best regarded as a multidimensional concept in which the level of experienced fatigue and the ability to perform activities are influenced by the type of disease, the health status of the patient and several aspects of patient functioning. A distinction is made between experienced fatigue and physiological fatigue, which can both be influenced by psycho-sociological factors [101]. The multidimensional concept of fatigue is depicted in Fig. 1. In this figure fatigue is integrated in the World Health Organization’s International Classification of Functioning, Disability and Health (WHO-ICF). The WHO-ICF represents the effect of disease on body function and structure and the level of activities and participation of the patient [1].Fig. 1


Fatigue in neuromuscular disorders: focus on Guillain-Barré syndrome and Pompe disease.

de Vries JM, Hagemans ML, Bussmann JB, van der Ploeg AT, van Doorn PA - Cell. Mol. Life Sci. (2010)

Fatigue as a multidimensional concept implemented in the World Health Organization’s Classification of Functioning, Disability, and Health. The multidimensional concept of fatigue is integrated in the World Health Organization’s International Classification of Functioning, Disability and Health (WHO-ICF), representing the effect of disease on body function and structure, activity and participation of the patient [1]. Both experienced fatigue and physiological fatigue have an effect on activity and participation and are in most diseases related to health status and disease severity. Psychosocial factors have an influence on fatigue and on activity and participation. The numbers indicate at which level the different treatment strategies have an effect on fatigue: I treatment of underlying disease; II rehabilitation and exercise; III pharmacotherapeutics; IV cognitive behavior therapy
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2824125&req=5

Fig1: Fatigue as a multidimensional concept implemented in the World Health Organization’s Classification of Functioning, Disability, and Health. The multidimensional concept of fatigue is integrated in the World Health Organization’s International Classification of Functioning, Disability and Health (WHO-ICF), representing the effect of disease on body function and structure, activity and participation of the patient [1]. Both experienced fatigue and physiological fatigue have an effect on activity and participation and are in most diseases related to health status and disease severity. Psychosocial factors have an influence on fatigue and on activity and participation. The numbers indicate at which level the different treatment strategies have an effect on fatigue: I treatment of underlying disease; II rehabilitation and exercise; III pharmacotherapeutics; IV cognitive behavior therapy
Mentions: Fatigue covers a broad spectrum of symptoms and complaints, and has no uniform definition. In clinical research, commonly used definitions of fatigue are an overwhelming and persistent feeling of tiredness and diminished ability to sustain voluntary mental and physical activities. In addition, weakness, lethargy and lack of energy that interfere with daily activities are used as definitions [9, 13, 22, 23, 29, 51, 53, 57, 107]. In basic neurosciences, it is defined as a time-related force decline [32, 102]. Considering the different aspects of fatigue it is best regarded as a multidimensional concept in which the level of experienced fatigue and the ability to perform activities are influenced by the type of disease, the health status of the patient and several aspects of patient functioning. A distinction is made between experienced fatigue and physiological fatigue, which can both be influenced by psycho-sociological factors [101]. The multidimensional concept of fatigue is depicted in Fig. 1. In this figure fatigue is integrated in the World Health Organization’s International Classification of Functioning, Disability and Health (WHO-ICF). The WHO-ICF represents the effect of disease on body function and structure and the level of activities and participation of the patient [1].Fig. 1

Bottom Line: Substantial high prevalence rates of fatigue are reported in a wide range of neuromuscular disorders, such as Guillain-Barré syndrome and Pompe disease.Treatment of fatigue in neuromuscular disease starts with symptomatic treatment of the underlying disease.When symptoms of fatigue persist, non-pharmacological interventions, such as exercise and cognitive behavioral therapy, can be initiated.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, Erasmus MC, University Medical Centre, Room Number EE 22-30, Dr. Molenwaterplein 50-60, Postbus 2040, 3000 CA Rotterdam, The Netherlands. j.m.devries@erasmusmc.nl

ABSTRACT
Fatigue accounts for an important part of the burden experienced by patients with neuromuscular disorders. Substantial high prevalence rates of fatigue are reported in a wide range of neuromuscular disorders, such as Guillain-Barré syndrome and Pompe disease. Fatigue can be subdivided into experienced fatigue and physiological fatigue. Physiological fatigue in turn can be of central or peripheral origin. Peripheral fatigue is an important contributor to fatigue in neuromuscular disorders, but in reaction to neuromuscular disease fatigue of central origin can be an important protective mechanism to restrict further damage. In most cases, severity of fatigue seems to be related with disease severity, possibly with the exception of fatigue occurring in a monophasic disorder like Guillain-Barré syndrome. Treatment of fatigue in neuromuscular disease starts with symptomatic treatment of the underlying disease. When symptoms of fatigue persist, non-pharmacological interventions, such as exercise and cognitive behavioral therapy, can be initiated.

Show MeSH
Related in: MedlinePlus