Table 6. Fatigue Study Outcomes.
| Author (Year) | Country | Fatigue |
| Akbar et al (2016)55 | Canada | Mean (SD) PedsQL™ multidimensional fatigue score (patients with MS ≤18 y vs non-MS self-reported healthy individuals): 30.4 (13.3) vs 22.6 (9.01) |
| Akbar et al (2016)56 | Canada | Mean (SD) PedsQL™ multidimensional fatigue score (patients with MS <18 y vs healthy controls): 30.8 (14.1) vs 21.9 (7.1) |
| Akbar et al (2016)57 | Canada | Mean (SD) PedsQL™ multidimensional fatigue score (patients with MS ≤18 y vs age- and sex-matched healthy controls): 30.0 (13.4) vs 23.3 (8.8) |
| Fuentes et al (2012)31 | Canada | 23% patients with RRMS <19 y experienced fatigue |
| Grover et al (2016)41 | Canada | Median (IQR, % moderate-to-severe) fatigue (Varni Pediatric QOL Inventory Multidimensional Fatigue) (patients with MS vs healthy controls) General: 7.0 (6.0, 15) vs 7.0 (3.0, 14) Cognitive: 7.0 (6.0, 19) vs 7.0 (7.0, 11) Mean (SD, % moderate-to-severe) fatigue Sleep/rest: 7.8 (4.8, 22) vs 9.3 (3.5, 22) Total: 21.3 (12.5; 15) vs 23.1 (8.2, 11) |
| Stephens et al (2019)48 | Canada | Baseline mean (SD) fatigue (PedsQL™) among patients with MS <18 y Total: 69.5 (16.5) General: 71.77 (18.9) Sleep/rest: 64.66 (19.88) Cognitive: 72.1 (21.0) Fatigue scores over time estimate (SE) Total: -2.84 (1.03) General: -3.68 (1.18) Sleep/rest: -2.62 (1.05) Cognitive: -1.59 (1.32) T values and P values also included |
| Till et al (2012)39 | Canada | Experienced chronic fatigue: 43.8% patients with RRMS <18 y vs 0% age- and sex-matched healthy controls |
| Florea et al (2020)30 | France | 43% moderate or severe fatigue on FSS |
| Storm van’s Gravesande et al (2019)26 | Germany, Austria | Mean (SD) self-reported fatigue scale scores (PedsQL™) (MS children, age-matched healthy controls) General: 63.15 (25.73), 77.64 (17.83) Sleep/rest: 55.46 (21.69), 63.15 (19.16) Cognitive: 65.99 (26.36), 74.52 (20.76) |
| Storm van’s Gravesande et al (2019)27 | Germany, Austria | Mean (SD) self-reported fatigue scale scores (PedsQL™) (patients with RRMS 12-18 y vs age-matched healthy controls) General: 63.15 (25.73) vs 77.64 (17.83) Sleep/rest: 55.46 (21.69) vs 63.15 (19.16) Cognitive: 65.99 (26.36) vs 74.52 (20.76) Total: 61.57 (20.78) vs 71.78 (15.58) Classification of total fatigue (%) (patients with MS vs age-matched healthy controls) None: 59.4 vs 82.8 Mild: 20.8 vs 14.4 Severe: 19.8 vs 2.9 Classification of general, sleep/rest, and cognitive fatigue also included |
| Kapanci et al (2019)40 | Germany | Mean (SD) fatigue per Modified Fatigue Impact Scale (patients with MS vs age-and sex-matched healthy controls): 32.52 (17.22) vs 23.10 (12.75) |
| Amato et al (2014)58 | Italy | 20% of patients with MS <18 y with fatigue on the FSS |
| Amato et al (2010)59 | Italy | 21% with fatigue on the FSS |
| De Meo et al (2017)37 | Italy | Mean (SD) FSS among patients with MS 7-18 y: 27.1 (12.1) |
| Goretti et al (2012)35 | Italy | Mean (SD) of self-reported fatigue (PedsQL™) (patients with MS ≤18 y vs demographically matched healthy controls) General: 78.5 (18.9) vs 74.2 (14.1) Sleep: 79.2 (14.3) vs 74.3 (14.5) Cognitive: 83.0 (15.0) vs 77.5 (17.9) |
| Pastò et al (2016)60 | Italy | Mean (SD) FSS for patients with RRMS <18 y with cognitive performance that is: Deteriorating: 3.3 (1.9) Stable/improving: 2.5 (1.8) |
| Rocca et al (2016)36 | Italy | Mean (SD) FSS All patients with RRMS 8-18 y: 27.2 (12.3) CP patients: 27.6 (11.8) CI patients: 26 (14.2) |
| Toussaint-Duyster et al (2018)28 | Netherlands | <1 SD below the mean on PedsQL™ fatigue scores among patients with MS 4-17 y Total: 36 General: 36 Sleep-rest: 27 Cognitive: 32 |
| Sandvig et al (2015)32 | Norway | 61.1% patients with RRMS <16 y reported fatigability |
| Carroll et al (2016)61 | UK | Five themes emerged from interviews with patients with MS 6-18 y: (1) emotional reactions to fatigue and its impact, (2) the lived experience of fatigue and impact on daily activities, (3) uncontrollability and unpredictability of fatigue (uncontrollability, uncertainty, and lack of knowledge), (4) finding a balance (concern about well-being, future), (5) social support and disclosure |
| Parrish et al (2013)62 | US, Canada | Mean (SD, % moderate-to-severe elevation) fatigue (n = 24) (Varni Pediatric QOL Inventory Multidimensional Fatigue) (patients with MS 10-18 years vs healthy controls) Total: 30.04 (18.48, 29.17) vs 20.03 (10.58, 8.62) General: 9.42 (6.42, 33.33) vs 4.91 (3.68, 3.45) Cognitive: 10.75 (7.26, 41.67) vs 7.05 (5.12, 20.69) Sleep/rest: 9.46 (6.37, 37.5) vs 8.05 (4.57, 20.69) |
| Charvet et al (2016)38 | US | Mean (SD, range) FSS among patients with MS 5-18 y: 30.06 (14.37, 9-53) (n = 46) |
| Holland et al (2014)63 | US | Mean (SD, range) PedsQL™ Multidimensional Fatigue Scale among patients with MS 7-18 y Cognitive: 61.80 (23.20, 17-106) Sleep/rest: 62.12 (22.50, 17-100) General: 66.88 (19.53, 25-100) Total: 63.08 (18.06, 25-100) |
| Zafar et al (2012)64 | US | Mean (SD) total scores (patients with MS 13-18 y vs healthy children in a historical control group) PedsQL™ Multidimensional Fatigue Scale: 61.53 (19.27) vs 61.06 (17.16) Adolescent Sleep-Wake Scale: 4.11 (0.89) vs 5.07 (0.77) Adolescent Sleep Hygiene Scale: 4.48 (0.64) vs 4.35 (0.56) Modified Epworth Sleepiness Scale: 7.00 (3.36) vs 9.44 (4.14) |
Abbreviations: CI, cognitively impaired; CP, cognitively preserved; FSS, Fatigue Severity Scale; IQR, interquartile range; PedsQL™, Pediatric Quality of Life; QOL, quality of life; RRMS, relapsing-remitting multiple sclerosis.
Control group data reported as applicable to outcome of interest.