Fatigued Patients Walk Slower, Endure Shorter Distances, Study Finds

Fatigue may compromise and predict Parkinson’s patients’ mobility and their ability to walk over long distances, according to a recent study.

The results of the study, “Can fatigue predict walking capacity of patients with Parkinson’s disease?” were published in Arquivos de Neuro-Psiquiatria.

Lack of energy, or fatigue is one of the most common — and most disabling — symptoms in Parkinson’s disease (PD), and has a significant impact on patients’ quality of life.

“Although fatigue is an important symptom in PD, only few studies have assessed its association with mobility, walking capacity, and physical activity in patients,” the researchers noted.

Fatigue has been shown — following freezing of gait and general self-walking difficulties — as the third strongest factor that independently contributes to walking problems among people with Parkinson’s. Freezing of gait is a Parkinson’s motor symptom in which a person’s feet feel like they’ve become briefly “glued to the floor,” preventing forward movement despite an intention to walk.

A team of Brazilian researchers now investigated whether fatigue can predict mobility and walking capacity among people with Parkinson’s.

A total of 48 patients — 27 men and 21 women, mean age 67.2 years — were involved in the study, with 22 diagnosed with fatigue as measured by the Parkinson’s Fatigue Scale. All had their mobility and walking capacity tested using clinically validated tools, namely the Timed Up and Go or TUG test, the 10-Meter Walk Test (at usual and fastest speed), and the 6-Minute Walk Test, or 6WMT. The 6WMT assesses the distance a person walks over six minutes as a measure of aerobic capacity and endurance. The 10-Meter test, which measures walking speed over a short distance, is used to determine functional mobility, gait, and vestibular function, located in the inner ear.

Compared with the non-fatigued patients, individuals with fatigue were older, had worse cognitive functions, more severe and advanced disease, higher motor impairment (as assessed by higher scores on the UPDRS scale), and higher levels of functional dependence according to the Schwab and England Activities of Daily Living Scale.

Fatigued patients also walked slower. The results showed they had smaller comfortable and maximum gait speeds and distance covered during the 6MWT than participants without fatigue.

Among all participants, 31.2% spent more than 16 seconds performing the Timed Up and Go test, which indicates an increased risk of falling.

Fatigue, age, and motor symptoms were found to predict the participants’ endurance and their ability to walk over longer distances, as measured by the 6-Minute Walk Test, with fatigue being the most significant predictor.

According to the researchers, a study limitation was that any links between antidepressants intake — known to influence Parkinson’s patients — and non-motor symptoms were not assessed.

“From a clinical perspective, our results suggest that fatigue may reduce functionality in everyday activities of PD patients and prolong periods of sedentary behaviors. This is particularly important seen that PD-related fatigue is one of the most common and disabling symptoms in these patients,” the researchers said.

“Our results highlight the importance of recognition and management of this symptom,” the team concluded.