Annual RIMS Conference: 4-6 June 2020, Leuven (BE)
Teaching Course: 'Motor & Cognitive Fatigability'
This teaching course will provide a taxonomy of fatigue, distinguishing trait and state fatigue where state fatigue refers to fatigability. Fatigability is defined as a change in perceived fatigue or objective performance of a task which can be situated in the motor or cognitive domain.
In this teaching course, we present the framework of fatigability and ongoing research, exemplify methodologies for measuring fatigability, discuss findings and clinical experience on the presence and relevance of fatigability in persons with MS, including the relation to fatigue.
The overall outline of the teaching course:
1) Taxonomy of Fatigue, and definition of fatigability
2) Motor fatigability at the ICF body function (muscular, energy cost) and activity level (walking and upper extremity) Measurement methods, Research findings, Workshop
3) Cognitive fatigability at the ICF body function level Measurement methods, Research findings, Workshop
4) Relation between fatigability and fatigue
5) Discussions on implications for clinical practice and potential rehabilitation interventions
6) Take home messages
Educational team, with a background in Rehabilitation Sciences & Physiotherapy, Movement Sciences, Exercise Physiology, Neuropsychology
  • Prof. Peter Feys, PhD student Fanny Van Geel, PhD student Kyra Theunissen, Msc Mieke D'Hooghe* 
           REVAL rehabilitation research center, UHasselt, Belgium *National MS Center 
  • Ass. Prof. Ulrik Dalgas, Dep. Public Health, Aarhus University Denmark 
  • PhD student Cintia Ramari, Faculty of Physical Education, University of Brasilia, Brasilia, Brazil  
  • Prof. Roshan Das Nair, University of Nottingham, Nottingham, UK 
Detailed programme
 by Peter Feys
 Introduction to Fatigue & fatigability: Taxonomy
 by Fanny Van Geel  
 Motor Fatigability
  • Measures during walking, and coordination tasks (Fanny Van Geel)
  • Investigating lower limb fatigability & voluntary drive (Ulrik Dalgas)
  • Investigating upper limb fatigability & voluntary drive (Peter Feys)
 Cognitive Fatigability
  •  Framework (Roshan Das Nair)
  •  Detecting cognitive fatigability in MS cognitive screening (Mieke  D’Hooge)
 12:00   Lunch
 Workshop: outcome measures
  • Motor fatigability: (assistance of Cintia Ramari)
            - lower limb muscular fatigue (Microfet)
        upper limb muscular fatigue indexes: JAMAR
        - walking 6MWT (DISTANCE/VAS/BORG) & Sit-to-Stance

  • Cognitive fatigability
        - PASAT & SDMT
 13:15  Group experiences & Reflections
1. Harrison AM, das Nair R, Moss-Morris R. Operationalising cognitive fatigability in multiple sclerosis: A Gordian knot that can be cut? Mult Scler. 2017;23(13):1682-96.
2. Severijns D, Zijdewind I, Dalgas U, Lamers I, Lismont C, Feys P. The Assessment of Motor Fatigability in Persons With Multiple Sclerosis: A Systematic Review. Neurorehabil Neural Repair. 2017;31(5):413-31.
3. Van Geel F, Veldkamp R, Severijns D, Dalgas U, Feys P. Day-to-day reliability, agreement and discriminative validity of measuring walking-related performance fatigability in persons with multiple sclerosis. Mult Scler. 2019:1352458519872465.
4. Severijns D, Cuypers K, Meesen R, Feys P, Zijdewind I. Force decline after low and high intensity contractions in persons with multiple sclerosis. Clin Neurophysiol. 2019;130(3):359-67.
5. Severijns D, Van Geel F, Feys P. Motor fatigability in persons with multiple sclerosis: Relation between different upper limb muscles, and with fatigue and the perceived use of the arm in daily life. Mult Scler Relat Disord. 2017;19:90-5.