Reliability and Validity of Self-Report Questionnaires as Indicators of Fatigue in RYR1-Related Disorders

J Neuromuscul Dis. 2019;6(1):133-141. doi: 10.3233/JND-180335.

Abstract

Background: RYR1-related disorders (RYR1-RD), are a spectrum of genetic neuromuscular disorders. Affected individuals frequently experience fatigue yet appropriate tools to assess RYR1-RD-associated fatigue remain underdeveloped.

Objective: This study assessed the reliability and validity of two self-report questionnaires, the multidimensional fatigue inventory (MFI-20) and adult/pediatric functional assessment of chronic illness-fatigue (FACIT-F/Peds-FACIT-F) as potential fatigue measures in RYR1-RD affected individuals.

Methods: Participants (n = 37) were enrolled in an RYR1-RD combined natural history study and clinical trial. At baseline, participants completed fatigue questionnaires, six-minute walk test (6MWT), cardiopulmonary exercise test (CPET) and saliva collection for fatigue biomarker index (FBI) quantification.

Results: All questionnaires exhibited good test-retest reliability (n = 18, ICC > 0.80). MFI-20 (n = 37), and FACIT-F (n = 28) also showed good internal consistency (Cronbach's α> 0.80). All MFI-20 subscales, except mental fatigue, and FACIT-F demonstrated evidence of criterion validity when correlated against percent predicted 6MWT distance (MFI-20 n = 37; r = -0.34 to -0.47, all p < 0.05, mental fatigue, r = -0.16, p = 0.35; FACIT-F n = 28, r = 0.41, p = 0.03). This was not the case for percent predicted VO2 peak (all p > 0.05). FBI correlated with MFI-20 general fatigue dimension only (r = -0.35, p = 0.03). Comparison of standardized questionnaire scores revealed that RYR1-RD affected individuals experience significantly greater fatigue than the general population.

Conclusions: MFI-20 and FACIT-F are valid and reliable tools for assessing RYR1-RD-associated fatigue, a symptom centrally implicated in this rare disorder.

Keywords: Fatigue; RYR1; myopathy; quality of life; ryanodine receptor.

Publication types

  • Clinical Trial

MeSH terms

  • Acetylcysteine / therapeutic use
  • Adolescent
  • Adult
  • Biomarkers / metabolism
  • Child
  • Exercise Test
  • Fatigue / diagnosis*
  • Fatigue / drug therapy
  • Fatigue / genetics
  • Fatigue / physiopathology
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Neuromuscular Agents / therapeutic use
  • Neuromuscular Diseases / diagnosis*
  • Neuromuscular Diseases / drug therapy
  • Neuromuscular Diseases / genetics*
  • Neuromuscular Diseases / physiopathology
  • Reproducibility of Results
  • Ryanodine Receptor Calcium Release Channel / genetics*
  • Saliva / metabolism
  • Self Report*

Substances

  • Biomarkers
  • Neuromuscular Agents
  • RYR1 protein, human
  • Ryanodine Receptor Calcium Release Channel
  • Acetylcysteine