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Shaheen Shah, PhD

Content writer – Clinical

Triggers and alleviating factors for fatigue in Parkinson's disease.

Published on: October 11, 2022

Original author: Iris Lin, Briana Edison, et al. (2021) (DOI: 10.1371/journal.pone.0245285)

Parkinson's disease (PD) is a progressive disorder that affects the nervous system. Symptoms start slowly. The first symptom may be a barely noticeable tremor in just one hand. Tremors are typical, but the disorder may also cause stiffness or slowing of movement. The face may show little or no expression in the early stages of Parkinson's disease. Parkinson's disease symptoms worsen as the condition progresses over time.​ Parkinson's disease is incurable, and medications might significantly improve the symptoms. Occasionally, surgery may be indicated to regulate certain brain regions and improve the symptoms.​ Fatigue is common in Parkinson's disease, but few effective treatments are available. Thus finding the possible triggers and alleviating factors, including the effects of exercise, could enlighten the development of management strategies for Parkinson's disease fatigue.​ In the current paper, the researchers examine triggers and alleviating factors for fatigue reported by individuals with Parkinson's disease. Methodology & results Fox Insight administered an online survey to a sample of 1029 individuals with self-reported Parkinson's disease participating in the study. The survey included the Parkinson's Fatigue Scale, the Physical Activity Scale for the Elderly, and multiple-choice questions about triggers and alleviating factors for fatigue.​ Among the sample of 1,029 individuals with Parkinson's disease, the mean (standard deviation (SD)) age was 67.4 (9.3) years, and 44.0% were female. Parkinson's Fatigue Scale score ranged from 16–80, mean (SD) of 48.8 (16.2).​ Factors such as poor sleep (62.1%) and physical exertion (45.1%) were frequently reported triggers for fatigue. Coping strategies include sitting quietly (58.1%), lying down with or without napping, and exercising (20%). Physical Activity Scale for the elderly scores was higher in those who reported that exercise alleviated their fatigue (49.7%) compared to those who wrote it worsened their fatigue (18.9%) (Mean (SD) score 158.5 (88.8) vs. 119.8 (66.6) respectively; p<0.001). Impact of research 1. This research is evidence for allied health professionals and physicians. 2. This study may benefit clinical trials investigating treatments for PD fatigue to differentiate by age and sex when examining treatment effects. Conclusion 1. The study describes some of the self-reported factors affecting fatigue in PD patients, such as physical activity, poor sleep, and stoppage of medications. 2. The exercise was reported to help fatigue in one-half of the patients but was perceived to worsen fatigue in others. 3. The results demonstrate that some patients can often recognize triggers for their fatigue; counseling patients can keep their symptoms low, or investigating their lifestyle and changing them may avoid triggers. 4. Patients use various coping mechanisms for their fatigue. The results suggest several essential approaches that require further research, such as intentional daytime napping, caffeine use, exercise, and methods to manage emotions. 5. Demographic variations in triggers and coping strategies indicate that an individualistic approach may be necessary. 6. Individuals with Parkinson's disease have several behavioral and environmental triggers and alleviating strategies for fatigue. Many feel that exercise relieves fatigue, though the relationship between activity and fatigue in Parkinson's disease appears complex. This exploratory study may pave way for the future development of treatments or coping strategies for Parkinson's disease fatigue.

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