Rheumatology International

, Volume 27, Issue 9, pp 847–852 | Cite as

Assessment of fatigue in patients with ankylosing spondylitis

  • Yasemin Turan
  • Mehmet Tuncay Duruöz
  • Serpil Bal
  • Anıl Guvenc
  • Lale Cerrahoglu
  • Alev Gurgan
Original Article

Abstract

In this study, we evaluated fatigue by using the multidimensional assessment of fatigue (MAF) index in 68 ankylosing spondylitis (AS) patients. To determine the disease activity, functional status and quality of life, bath ankylosing spondylitis disease activity index (BASDAI), bath ankylosing spondylitis functional index (BASFI) and Short Form 36 (SF36) were used respectively. Mander enthesis index (MEI) was used for evaluation of enthesitis. The mean age of the patients was 37.7 (11.1) years. The prevalence of fatigue was 76.5%. There were significant correlations between MAF and BASDAI (P < 0.001), BASFI (P < 0.001), MEI (P = 0.048), pain (P = 0.001), hemoglobin (P = 0.001), ESR (P = 0.035), dorsal Schober’s (P = 0.009), occiput–wall distance (P = 0.048). Also MAF was correlated with all dimensions of SF36 except for social function and emotional role. BASFI was found to be the most significant correlated (P = 0.002) parameter with MAF. This study suggests that fatigue is an important symptom in AS and it seemed to occur in severe AS patients. It should appropriately be measured with respect to its intensity with appropriate measures, such as MAF. Moreover, fatigue may increase functional disability, which is already present as a feature of the disease.

Keywords

Ankylosing spondylitis Fatigue Disease severity Health-related quality of life 

References

  1. 1.
    Van der Linden S, Van der Heijde D, Braun J (2005) Spondyloarthropathies: ankylosing spondylitis. In: Harris (Ed) Kelley’s textbook of rheumatology, 7th edn. Elsevier, Philadelphia, pp 1125–1142Google Scholar
  2. 2.
    Khan MA (2002) Update on spondyloarhropathies. Ann Intern Med 136:896–907PubMedGoogle Scholar
  3. 3.
    Braun J, Bollow M, Siper J (1998) Radiologic diagnosis and pathology of the spondyloarthropathies. Rheum Dis Clin North Am 24:697–735PubMedCrossRefGoogle Scholar
  4. 4.
    Ward MM (1999) Health-related quality of life in ankylosing spondylitis: a survey of 175 patients. Arthritis Care Res 12:247–255PubMedCrossRefGoogle Scholar
  5. 5.
    Calin A, Edmunds L, Kennedy LG (1993) Fatigue in ankylosing spondylitis: why is it ignored? J Rheumatol 20:991–995PubMedGoogle Scholar
  6. 6.
    Belza BL (1995) Comparison of self-reported fatigue in rheumatoid arthritis and controls. J Rheumatol 22:639–643PubMedGoogle Scholar
  7. 7.
    Belza BL, Henke CJ, Yelin EH, Epstein WV, Gilliss CL (1993) Correlates of fatigue in older adults with Rheumatoid Arthritis. Nurs Res 42:93–99PubMedCrossRefGoogle Scholar
  8. 8.
    Van der Linden S, Valkenburg HA, Cats A (1984) Evaluation of diagnostic criteria for ankylosing spondylitis: a proposal for the modification of the New York criteria. Arthritis Rheum 27:361–368PubMedCrossRefGoogle Scholar
  9. 9.
    Garrett SL, Jenkinson TR, Kennedy LG, Whitelock HC, Gaisford P, Calin A (1994) A new approach to defining disease status in ankylosing spondylitis: the bath ankylosing spondylitis disease activity index. J Rheumatol 21:2286–2291PubMedGoogle Scholar
  10. 10.
    Akkoc Y, Karatepe AG, Akar S, Kirazli Y, Akkoc N (2005) A Turkish version of the bath ankylosing spondylitis disease activity index: reliability and validity. Rheumatol Int 25(4):280–284PubMedCrossRefGoogle Scholar
  11. 11.
    Calin A, Garrett SL, Whitelock HC, Kennedy LG, O’Hea J, Mallorie P, Jenkinson T (1994) A new approach to defining functional ability in ankylosing spondylitis: the development of the bath ankylosing spondylitis functional index (BASFI). J Rheumatol 21:2281–2285PubMedGoogle Scholar
  12. 12.
    Yanik B, Gursel YK, Kutlay S, Ay S, Elhan AH (2005) Adaptation of the bath ankylosing spondylitis functional index to the Turkish population, its reliability and validity: functional assessment in AS. Clin Rheumatol 24(1):41–47PubMedCrossRefGoogle Scholar
  13. 13.
    Mander M, Simpson JM, Mc Lellan A, Walker D, Goodacre JA, Dick WC (1987) Studies with an enthesis index as a method of clinical assesment in ankylosing spondylitis. Ann Rheum Dis 46:197–202PubMedGoogle Scholar
  14. 14.
    Ware JE Jr (2000) SF-36 health survey update. Spine 25:3130–3139Google Scholar
  15. 15.
    Koçyiğit H, Aydemir Ö, Fişek G et al (1999) Kısa Form 36’nın Türkçe Versiyonunun Güvenilirliği ve Geçerliliği. İlaç ve Tedavi Dergisi 12:102–106Google Scholar
  16. 16.
    Dagfinrud H, Vollestad NK, Loge JH, Kvien TK, Mengshoel AM (2005) Fatigue in patients with ankylosing spondylitis: a comparison with the general population and associations with clinical and self-reported measures. Arthritis Rheum 53(1):5–11PubMedCrossRefGoogle Scholar
  17. 17.
    Van Tubergen A, Coenen J, Landewe R, Spoorenberg A, Chorus A, Boonen A, van der Linden S, van der Heijde D (2002) Assessment of fatigue in patients with ankylosing spondylitis: a psychometric analysis. Arthritis Rheum 47(1):8–16PubMedCrossRefGoogle Scholar
  18. 18.
    Da Costa D, Dritsa M, Ring A, Fitzcharles MA (2004) Mental health status and leisure-time physical activity contribute to fatigue intensity in patients with spondylarthropathy. Arthritis Rheum 15:1004–1008CrossRefGoogle Scholar
  19. 19.
    Jones SD, Koh WH, Steiner A, Garrett SL, Calin A (1996) Fatigue in ankylosing spondylitis: its prevalence and relationship to disease activity, sleep, and other factors. J Rheumatol 23:487–490PubMedGoogle Scholar
  20. 20.
    Riemsma RP, Rasker JJ, Taal E, Griep EN, Wouters JM, Wiegman O (1998) Fatigue in rheumatoid arthritis: the role of self-efficacy and problematic social support. Br J Rheumatol 37(10):1042–1046PubMedCrossRefGoogle Scholar
  21. 21.
    Fuhrer R, Wessley S (1995) The epidemiology of fatigue and depression: a French primary-care study. Psychol Med 25:895–905PubMedCrossRefGoogle Scholar
  22. 22.
    Kirk KM, Hickie IB, Martin NG (1999) Fatigue as related to anxiety and depression in a community-based sample of twins aged over 50. Soc Psychiatry Psychiatr Epidemiol 34:85–90PubMedCrossRefGoogle Scholar
  23. 23.
    Koschera A, Hickie I, Hadzi-Pavlovic D, Wilson A, Llyod A (1999) Prolonged fatigue, anxiety and depression: exploring relationships in a primary care sample. Aust N Z J Psychiatry 33:545–552PubMedCrossRefGoogle Scholar
  24. 24.
    Schneider RA (1998) Concurrent validity of the Beck depression inventory and the Multidimensional Fatigue Inventory-20 in assessing fatigue among cancer patients. Psychol Rep 82:883–886PubMedCrossRefGoogle Scholar
  25. 25.
    Barnes EA, Bruera E (2002) Fatigue in patients with advanced cancer: a review. Int J Gynecol Cancer 12:424–428PubMedCrossRefGoogle Scholar
  26. 26.
    Palumbo A, Petrucci MT, Lauta VM (2005) Correlation between fatigue and hemoglobin level in multiple myeloma patients: results of a cross-sectional study. Haematologica 90(6):858–860PubMedGoogle Scholar
  27. 27.
    Dernis-Labous E, Messow M, Dougados M (2003) Assessment of fatigue in the management of patients with ankylosing spondylitis. Rheumatology (Oxford) 42:1523–1528CrossRefGoogle Scholar
  28. 28.
    Spoorenberg A, van der Heijde D, de Klerk E et al (1999) Relative value of erythrocyte sedimentation rate and C-reactive protein in assessment of disease activity in ankylosing spondylitis. J Rheumatol 26:980–984PubMedGoogle Scholar
  29. 29.
    Ruof J, Stucki G (1999) Validity aspects of erythrocyte sedimentation rate and C-reactive protein in ankylosing spondylitis: a literature review. J Rheumatol 26:966–970PubMedGoogle Scholar
  30. 30.
    Bostan EE, Borman P, Bodur H, Barca N (2003) Functional disability and quality of life in patients with ankylosing spondylitis. Rheumatol Int 23:121–126PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Yasemin Turan
    • 1
    • 3
  • Mehmet Tuncay Duruöz
    • 2
  • Serpil Bal
    • 1
  • Anıl Guvenc
    • 1
  • Lale Cerrahoglu
    • 2
  • Alev Gurgan
    • 1
  1. 1.Department of Physical Medicine and RehabilitationAtatürk Research and Education HospitalIzmirTurkey
  2. 2.Department of Physical Medicine and RehabilitationCelal Bayar University School of MedicineManisaTurkey
  3. 3.IzmirTurkey

Personalised recommendations