Skip to main content

Advertisement

SpringerLink
Log in

The Parkinson fatigue scale: an evaluation of its validity and reliability in Greek Parkinson’s disease patients

  • Original Article
  • Published:
Neurological Sciences Aims and scope Submit manuscript

Abstract

Objective

Fatigue is one of the most frequent and important nonmotor symptoms of patients with Parkinson disease (PD), affecting quality of life. Although, in some cases, it may be a severe and debilitating complaint, it remains relatively unexplored. The PFS-16 is a fatigue measure, specifically designed for PD patients. The aim of this study was to investigate the psychometric properties of Parkinson fatigue scale (PFS-16) in Greek PD patients.

Methods

In total, 99 patients with PD were assessed. The following psychometric properties were tested: data quality, floor/ceiling effects, reliability (internal consistency, test–retest reliability), and construct validity. Construct validity was evaluated by examining correlations with other variables including other fatigue measures such as Fatigue Severity Scale (FSS) and the vitality scale (SF-VT) of SF-36. Moreover, assumptions were explored about “known” groups concerning fatigue.

Results

The mean score for the PFS-16 was 2.95 (± 0.91); acceptability was good with negligible floor and ceiling effects. Results showed high internal consistency (Cronbach’s alpha, 0.96) and test–retest reliability (ICC, 0.93). Strong correlations were observed between the PFS-16 and other fatigue (FFS and SF-VT) measures (rs = 0.77 and − 0.70, p < 0.001), revealing appropriate validity. Furthermore, predictions for “known” groups validity were verified.

Conclusion

The Greek version of the PFS-16 showed satisfactory reliability and validity and thus can be regarded as a useful tool in assessing fatigue in PD.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Pfeiffer RF (2016) Non-motor symptoms in Parkinson’s disease. Parkinsonism Relat Disord 22(Suppl 1):S119–S122

    Article  Google Scholar 

  2. Metta V, et al. (2011) The possible clinical predictors of fatigue in Parkinson’s disease: a study of 135 patients as part of international nonmotor scale validation project. Parkinsons Dis, 2011. p. 125271

  3. Goldman JG, Stebbins GT, Leung V, Tilley BC, Goetz CG (2014) Relationships among cognitive impairment, sleep, and fatigue in Parkinson’s disease using the MDS-UPDRS. Parkinsonism Relat Disord 20(11):1135–1139

    Article  Google Scholar 

  4. Kluger BM, Herlofson K, Chou KL, Lou JS, Goetz CG, Lang AE, Weintraub D, Friedman J (2016) Parkinson’s disease-related fatigue: a case definition and recommendations for clinical research. Mov Disord 31(5):625–631

    Article  Google Scholar 

  5. Friedman JH, Brown RG, Comella C, Garber CE, Krupp LB, Lou JS, Marsh L, Nail L, Shulman L, Taylor CB, Working Group on Fatigue in Parkinson's Disease (2007) Fatigue in Parkinson’s disease: a review. Mov Disord 22(3):297–308

    Article  Google Scholar 

  6. Barone P, Antonini A, Colosimo C, Marconi R, Morgante L, Avarello TP, Bottacchi E, Cannas A, Ceravolo G, Ceravolo R, Cicarelli G, Gaglio RM, Giglia RM, Iemolo F, Manfredi M, Meco G, Nicoletti A, Pederzoli M, Petrone A, Pisani A, Pontieri FE, Quatrale R, Ramat S, Scala R, Volpe G, Zappulla S, Bentivoglio AR, Stocchi F, Trianni G, Dotto PD, on behalf of the PRIAMO study group (2009) The PRIAMO study: a multicenter assessment of nonmotor symptoms and their impact on quality of life in Parkinson’s disease. Mov Disord 24(11):1641–1649

    Article  Google Scholar 

  7. Karlsen K, Larsen JP, Tandberg E, Jørgensen K (1999) Fatigue in patients with Parkinson’s disease. Mov Disord 14(2):237–241

    Article  Google Scholar 

  8. Stocchi F, Abbruzzese G, Ceravolo R, Cortelli P, D'Amelio M, de Pandis MF, Fabbrini G, Pacchetti C, Pezzoli G, Tessitore A, Canesi M, Iannacone C, Zappia M, For the FORTE Study Group (2014) Prevalence of fatigue in Parkinson disease and its clinical correlates. Neurology 83(3):215–220

    Article  Google Scholar 

  9. Alves G, Wentzel-Larsen T, Larsen JP (2004) Is fatigue an independent and persistent symptom in patients with Parkinson disease? Neurology 63(10):1908–1911

    Article  Google Scholar 

  10. Friedman JH, Abrantes A, Sweet LH (2011) Fatigue in Parkinson’s disease. Expert Opin Pharmacother 12(13):1999–2007

    Article  Google Scholar 

  11. Chaudhuri A, Behan PO (2004) Fatigue in neurological disorders. Lancet 363(9413):978–988

    Article  Google Scholar 

  12. Friedman JH et al (2016) Fatigue in Parkinson’s disease: report from a mutidisciplinary symposium. NPJ Parkinsons Dis 2

  13. Brown RG, Dittner A, Findley L, Wessely SC (2005) The Parkinson fatigue scale. Parkinsonism Relat Disord 11(1):49–55

    Article  Google Scholar 

  14. Friedman JH, Alves G, Hagell P, Marinus J, Marsh L, Martinez-Martin P, Goetz CG, Poewe W, Rascol O, Sampaio C, Stebbins G, Schrag A (2010) Fatigue rating scales critique and recommendations by the movement disorders society task force on rating scales for Parkinson’s disease. Mov Disord 25(7):805–822

    Article  Google Scholar 

  15. Kummer A, Scalzo P, Cardoso F, Teixeira AL (2011) Evaluation of fatigue in Parkinson’s disease using the Brazilian version of Parkinson’s Fatigue Scale. Acta Neurol Scand 123(2):130–136

    Article  Google Scholar 

  16. Hagell P, Rosblom T, Palhagen S (2012) A Swedish version of the 16-item Parkinson fatigue scale (PFS-16). Acta Neurol Scand 125(4):288–292

    Article  Google Scholar 

  17. Fu R, Cui SS, du JJ, Huang P, He YC, Gao C, Luo XG, Chen SD (2017) Validation of the Parkinson Fatigue Scale in Chinese Parkinson’s disease patients. Brain Behav 7(6):e00712

    Article  Google Scholar 

  18. Ozturk EA, Kocer BG, Umay E, Cakci A (2018) Cross-cultural adaptation and psychometric evaluations of the Turkish version of Parkinson Fatigue Scale. Qual Life Res 27:2719–2730

    Article  Google Scholar 

  19. Hughes AJ, Daniel SE, Kilford L, Lees AJ (1992) Accuracy of clinical diagnosis of idiopathic Parkinson’s disease: a clinico-pathological study of 100 cases. J Neurol Neurosurg Psychiatry 55(3):181–184

    Article  Google Scholar 

  20. Tomlinson CL, Stowe R, Patel S, Rick C, Gray R, Clarke CE (2010) Systematic review of levodopa dose equivalency reporting in Parkinson’s disease. Mov Disord 25(15):2649–2653

    Article  Google Scholar 

  21. Wild D, Grove A, Martin M, Eremenco S, McElroy S, Verjee-Lorenz A, Erikson P (2005) Principles of good practice for the translation and cultural adaptation process for patient-reported outcomes (PRO) measures: report of the ISPOR task force for translation and cultural adaptation. Value Health 8(2):94–104

    Article  Google Scholar 

  22. Nilsson MH, Bladh S, Hagell P (2013) Fatigue in Parkinson’s disease: measurement properties of a generic and a condition-specific rating scale. J Pain Symptom Manag 46(5):737–746

    Article  Google Scholar 

  23. Krupp LB, LaRocca N, Muir-Nash J, Steinberg AD (1989) The fatigue severity scale. Application to patients with multiple sclerosis and systemic lupus erythematosus. Arch Neurol 46(10):1121–1123

    Article  Google Scholar 

  24. Katsarou Z et al (2007) Immune factors or depression? Fatigue correlates in Parkinson’s disease. Rev Neurol 45(12):725–728

    Google Scholar 

  25. Hadjimichael O, Vollmer T, Oleen-Burkey M (2008) Fatigue characteristics in multiple sclerosis: the North American Research Committee on Multiple Sclerosis (NARCOMS) survey. Health Qual Life Outcomes 6:100

    Article  Google Scholar 

  26. Bakalidou D, Skordilis EK, Giannopoulos S, Stamboulis E, Voumvourakis K (2013) Validity and reliability of the FSS in Greek MS patients. Springerplus 2(1):304

    Article  Google Scholar 

  27. Hoehn MM, Yahr MD (1967) Parkinsonism: onset, progression and mortality. Neurology 17(5):427–442

    Article  Google Scholar 

  28. Goetz CG, Fahn S, Martinez-Martin P, Poewe W, Sampaio C, Stebbins GT, Stern MB, Tilley BC, Dodel R, Dubois B, Holloway R, Jankovic J, Kulisevsky J, Lang AE, Lees A, Leurgans S, LeWitt PA, Nyenhuis D, Olanow CW, Rascol O, Schrag A, Teresi JA, van Hilten JJ, LaPelle N (2007) Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS): process, format, and clinimetric testing plan. Mov Disord 22(1):41–47

    Article  Google Scholar 

  29. Cohen, J., Statistical power analysis for the behavioral sciences. 2nd ed. ed. 1988, Hillsdale, N.J.: L. Erlbaum Associates

  30. McHorney CA, Tarlov AR (1995) Individual-patient monitoring in clinical practice: are available health status surveys adequate? Qual Life Res 4(4):293–307

    Article  Google Scholar 

  31. Nunnally, J.C. and I.H. Bernstein, Psychometric theory. 3rd ed. ed. 1994, New York ; London: McGraw-Hill

  32. Streiner, D.L. and G.R. Norman, Health measurement scales: a practical guide to their development and use. 4th ed. ed. 2008, Oxford: Oxford University Press

  33. Bowling A (2009) Research methods in health: investigating health and health services. 3rd ed. ed. Maidenhead: Open University Press

  34. Solla P, Cannas A, Mulas CS, Perra S, Corona A, Bassareo PP, Marrosu F (2014) Association between fatigue and other motor and non-motor symptoms in Parkinson’s disease patients. J Neurol 261(2):382–391

    Article  Google Scholar 

  35. Fu R, Luo XG, Ren Y, He ZY, Lv H (2016) Clinical characteristics of fatigued Parkinson’s patients and the response to dopaminergic treatment. Transl Neurodegener 5:9

    Article  Google Scholar 

  36. Storch A, Schneider CB, Wolz M, Sturwald Y, Nebe A, Odin P, Mahler A, Fuchs G, Jost WH, Chaudhuri KR, Koch R, Reichmann H, Ebersbach G (2013) Nonmotor fluctuations in Parkinson disease: severity and correlation with motor complications. Neurology 80(9):800–809

    Article  Google Scholar 

  37. Franke C, Storch A (2017) Nonmotor fluctuations in Parkinson’s disease. Int Rev Neurobiol 134:947–971

    Article  Google Scholar 

  38. Grace J, Mendelsohn A, Friedman JH (2007) A comparison of fatigue measures in Parkinson’s disease. Parkinsonism Relat Disord 13(7):443–445

    Article  Google Scholar 

  39. Okuma Y, Kamei S, Morita A, Yoshii F, Yamamoto T, Hashimoto S, Utsumi H, Hatano T, Hattori N, Matsumura M, Takahashi K, Nogawa S, Watanabe Y, Miyamoto T, Miyamoto M, Hirata K (2009) Fatigue in Japanese patients with Parkinson’s disease: a study using Parkinson fatigue scale. Mov Disord 24(13):1977–1983

    Article  Google Scholar 

  40. Skorvanek M, Gdovinova Z, Rosenberger J, Ghorbani Saeedian R, Nagyova I, Groothoff JW, van Dijk JP (2015) The associations between fatigue, apathy, and depression in Parkinson’s disease. Acta Neurol Scand 131(2):80–87

    Article  Google Scholar 

Download references

Acknowledgements

We gratefully thank Prof. Brown for his permission to translate and use the PFS-16 in this study and for his useful remarks.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

Author information

Authors and Affiliations

  1. 3rd Department of Neurology, Aristotle University of Thessaloniki, G. Papanikolaou Hospital, Thessaloniki, Greece

    Ioannis E. Dagklis, Dimitrios Kazis, Varvara Theodoridou, Sotirios Papagiannopoulos, Dimitrios Ntantos & Sevasti Bostantjopoulou

  2. Laboratory of Primary Health Care, General Practice and Health Services Research - Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Efthymia Tsantaki

Authors
  1. Ioannis E. Dagklis
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Efthymia Tsantaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Dimitrios Kazis
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Varvara Theodoridou
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sotirios Papagiannopoulos
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Dimitrios Ntantos
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Sevasti Bostantjopoulou
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ioannis E. Dagklis.

Ethics declarations

The study was carried out in accordance with the Declaration of Helsinki on Ethical Principles for Medical Research.

Conflicting interests

The authors declare that they have no conflict of interest.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Dagklis, I.E., Tsantaki, E., Kazis, D. et al. The Parkinson fatigue scale: an evaluation of its validity and reliability in Greek Parkinson’s disease patients. Neurol Sci 40, 683–690 (2019). https://doi.org/10.1007/s10072-018-3695-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10072-018-3695-5

Keywords

Search

Navigation