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project R-8214

Title : Motor fatigability in relation to walking quality and energy expenditure: understanding its relative impact on perceived fatigue and physical activity behavior in persons with Multiple Sclerosis and Rheumatoid Arthritis. (R-8214)
Abstract: Fatigue is a very disabling symptom of persons with multiple sclerosis (PwMS) and persons with rheumatoid arthritis (pwRA), interfering in daily living. Motor fatigability can be defined as a decline in performance during gait, as revealed by reduced walking speed and quality. The manifestation of abnormal walking and fatigability may be the result of central neural governance or peripheral factors such as like joint inflammation or damage, as well as be linked to an increased energy expenditure and fatigue perception. It is hypothesized that the interplay of above-mentioned factors are determining actual daily life physical activity and participation more than just measuring muscular power or walking speed during short distances. This project has the aim to understand the relation between motor fatigability and energy expenditure in relation to the quality of walking, and the impact of dysfunctions on perceived fatigue actual physical activity behaviour and participation. This research will be performed in pathological conditions with symptomatic and disease similarities and differences, being MS and RA in order to understand generic and pathology-specific relations. Firstly, we will review assessment protocols and their psychometric properties of different motor fatigability outcome measures during walking, and summarize the current knowledge of factors contributing to physical activity behaviour. A literature review will be performed across any pathology and age range. Secondly, a selection of tests will be applied in healthy subjects, pwMS and pwRA to validate tests to assess motor fatigability and walking quality (reliability, construct validity), Thirdly, in a large cross sectional study, again among patients pwMS, psRA and HS, we will t to understand the independent contribution of walking quality and fatigability on fatigue and daily physical activity in the community measured with innovative wearables and questionnaires, while adjusting for disease specific and (personal and environmental) contextual factors . Finally, proof-of-concept pilot interventions will be performed to investigate effects of medical and non-medical interventions on walking kinematics and energy expenditure in relation with physical activity behaviour.
Period of project : 1/09/2017to31/08/2021