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RehabMeasures Instrument

Fatigue Scale for Motor and Cognitive Functions

Last Updated

Purpose

The FSMC is a 20-item sclae developed as a measure of cognitive and motor fatigue for people with MS.

Link to Instrument

Instrument Details

Acronym FSMC

Area of Assessment

Cognition
Gait

Assessment Type

Patient Reported Outcomes

Administration Mode

Paper & Pencil

Cost

Free

Diagnosis/Conditions

  • Multiple Sclerosis

Key Descriptions

  • Instructions refer to a general time frame rather than a fixed time frame.
  • This measure has been translated into 20 languages.

Number of Items

20

Time to Administer

5 minutes

Required Training

No Training

Age Ranges

Adult

18 - 64

years

Elderly Adult

65 +

years

Instrument Reviewers

Initially reviewed by Gail L. Widener, PT, PhD and the MS EDGE task force of the neurology section of the APTA in 2011.

ICF Domain

Body Structure
Body Function

Measurement Domain

Cognition
Motor

Professional Association Recommendation

Recommendations for use of the instrument from the Neurology Section of the American Physical Therapy Association’s Multiple Sclerosis Taskforce (MSEDGE), Parkinson’s Taskforce (PD EDGE), Spinal Cord Injury Taskforce (PD EDGE), Stroke Taskforce (StrokEDGE), Traumatic Brain Injury Taskforce (TBI EDGE), and Vestibular Taskforce (Vestibular EDGE) are listed below. These recommendations were developed by a panel of research and clinical experts using a modified Delphi process.

For detailed information about how recommendations were made, please visit:  

Abbreviations:

 

HR

Highly Recommend

R

Recommend

LS / UR

Reasonable to use, but limited study in target group  / Unable to Recommend

NR

Not Recommended

 

Recommendations based on level of care in which the assessment is taken:

 

 

Acute Care

Inpatient Rehabilitation

Skilled Nursing Facility

Outpatient

Rehabilitation

Home Health

MS EDGE

R

R

R

R

R

 

Recommendations based on EDSS Classification:

 

 

EDSS 0.0 – 3.5

EDSS 4.0 – 5.5

EDSS 6.0 – 7.5

EDSS 8.0 – 9.5

MS EDGE

R

R

R

R

 

Recommendations for entry-level physical therapy education and use in research:

 

 

Students should learn to administer this tool? (Y/N)

Students should be exposed to tool? (Y/N)

Appropriate for use in intervention research studies? (Y/N)

Is additional research warranted for this tool (Y/N)

MS EDGE

Yes

Yes

Yes

No

Considerations

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Multiple Sclerosis

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Test/Retest Reliability

Multiple Sclerosis (MS):

(Penner et al, 2009; = 309 MS patients and 147 healthy controls in the validation study)

  • Excellent test retest reliability for total, motor and cognitive (r = 0.86; r = 0.86; r = 0.85)

Construct Validity

Multiple Sclerosis:

(Penner et al, 2009)

  • Excellent FSMC convergent correlation with fatigue severity scale (FSS), (r = 0.797) and the modified fatigue impact scale (MFIS) (r = 0.829)
  • Adequate convergent correlation with the neurologist’s rating of fatigue (r = 0.508)
  • Poor FSMC-motor convergent correlation the MSFC-9HPT and -25FTW (r = 0.22)
  • Adequate FSMC-motor convergent correlation with the EDSS (= 0.38) 
  • Excellent FSMC-motor convergent correlation with the MSIF-motor (r = 0.804) 
  • Poor FSMC-cognitive convergent correlation with the paced auditory serial addition test (PASAT), (r = 0.27) 
  • Excellent FSMC-cognitive convergent correlation with the MSIF-cognitive (r = 0.832) 
  • Adequate FSMC total score, FSMC-motor and FSMC-cognitive convergent correlation with depression measured by the Beck Depression inventory (r = 0.49, r = 0.42, and r = 0.47)

Responsiveness

Multiple Sclerosis:

(Penner et al, 2009) 

  • FSMC total score had 88.7 sensitivity and 83.7 speficificity in differentiating pwMS from healthy controls, the FSMC-motor score had slightly higher sensitivity (89.0) and speficificty (86.4) using logistic regression, these values were higher than those found for either MSIF (sensitivity = 87.1, specificity = 71.4) or the FSS (sensitivity = 86.7, specificity = 69.4)

Bibliography

Penner, I. K., Raselli, C., et al. (2009). "The Fatigue Scale for Motor and Cognitive Functions (FSMC): validation of a new instrument to assess multiple sclerosis-related fatigue." Mult Scler 15(12): 1509-1517.