COSMIN database

How to measure fatigue in neurological conditions? A systematic review of psychometric properties and clinical utility of measures used so far

Tyson, S. F. and Brown, P.
Objective:To systemically review the psychometric properties and clinical utility (feasibility) of tools to measure fatigue in neurological conditions.Data sources:AMED, CINAHL, MEDLINE, Science Direct and Web of Knowledge were searched for studies of the psychometric properties of fatigue measures in adults with central nervous system disorders. Search terms were: Fatigue AND assess* OR measure* OR tool OR outcome OR index OR test OR scale AND stroke OR cerebrovascular* OR hemi* OR parkinson* OR sclerosis OR head injury OR brain injury OR motor neurone disease OR neuro*Review methods:Articles that addressed validity; reliability and ability to detect change were selected. Two authors independently selected articles and extracted data. Strength of the psychometric properties and clinical utility were assessed against predetermined thresholds.Results:A total of 25 articles were selected and 17 measurement tools identified including six versions of the Fatigue Severity Scale and five versions of the Fatigue Impact Scale. All were clinically feasible but none met all the criteria. Most were valid. Reliability and ability to detect change were infrequently evaluated, but were adequate when reported. The most thoroughly developed and psychometrically robust measures were the Neurological Fatigue Indices.Conclusion:Although many measures of fatigue in neurological conditions have published, none met all of the criteria for psychometric robustness and clinical utility but the Neurological Fatigue Indices are the best and can be used with caution
Clinical Rehabilitation
Publication year:
Symptom status:
Physical state
Functional status:
Physical functioning
Social functioning
Adults (18-65)
Seniors (65+)
Diseases of and symptoms related to the nervous system
PRO / non-PRO:
Patient Reported Outcome
Type of measurement instrument:
1 - Questionnaires
2 - Interviews
D-FIS - Fatigue impact scale for daily use [Alias: FIS-D - Fatigue Impact Scale for Daily Administration]
FACIT-Fatigue - Functional Assessment of Chronic Illness Therapy- Fatigue Scale
FAS - Fatigue Assessment Scale
FIS / FFSS - Fatigue Impact Scale (FIS) or Fisk Fatigue Severity Score (FFSS)
FSS - Fatigue Severity Scale (versions: FSS-7 - 7-item version and FSS-5 - 5-item version)   
MAF - Multidimensional Assessment of Fatigue
MFIS - Modified Fatigue Impact Scale [Alias: MFIS C-5 or MFIS P-8 - Modified fatigue impact scale cognitive and physical]   
MFSS - Multiple sclerosis-specific fatigue severity scale
NFI-MND - Neurological Fatigue Index (NFI) for Motor Neurone Disease
NFI-MS - Neurological fatigue index for multiple sclerosis
NFI-Stroke - Neurological Fatigue Index-Stroke
POMS - Profile of Mood States
U-FIS - Unidimensional fatigue impact scale