Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.


To Explore the Use of the PedsQL Subjective Questionnaire To Assess Levels of Fatigue in Children with Juvenile Dermatomyositis.

Maillard1,  Susan M., Todd2,  Amy, Nistala3,  Kiran, Pilkington2,  Clarissa, Hassan2,  Abdul

Great Ormond Street Hospital, London, Maidenhead, United Kingdom
Great Ormond Street Hospital, London
Institute of Child Health, London

Background:

Fatigue is one of the regularly reported clinical features of Juvenile Dermatomyositis (JDM), however there is no standardised method of assessing the degree of fatigue. The PedsQL Fatigue score (FS) is a self reported questionnaire and a Visual Analogue Scale (FVAS) which has been developed to measure fatigue in children with paediatric inflammatory diseases. Great Ormond Street Hospital has a specialist service for children with JDM and the FS and FVAS were used to assess whether they were an effective measure of disease related fatigue.

Objectives:

To establish if the PedsQL FS measures fatigue in children with JDM compared to clinical outcome measures of active JDM including muscle strength and function.

Methods:

All children attending the JDM clinic were routinely assessed using the Childhood Myositis Assessment Score (CMAS), manual muscle testing score (MMT8), parental VAS score of general wellbeing (PaVAS), physicians VAS of disease activity (PVAS), 6 minute walk test (6MWT) and Childhood Health Assessment Questionnaire (CHAQ). The PedsQL questionnaire was given out separately to both parents and children and includes a fatigue VAS (FVAS), a pain VAS as well as specific questions about cognitive fatigue, physical activity and sleep. The data was analysed using SPSS v16.0.

Results:

The patient cohort comprised of 52 children (39 F: 13 M). The mean age was 11.92 years (range 3–19). The mean disease duration was 9.42 years (range 0.2–13yrs)

The PedsQL FS (both parent and child) showed statistical significance with pain VAS, Pa VAS and CHAQ however did not show significance with the objective markers- MMT8 and CMAS. The child and parent FVAS shows statistically significant results with the pain VAS, MMT8 and the CHAQ. Additionally, the child FVAS statistically shows a correlation with the CMAS. Neither the PedsQL FS or FVAS showed any statistical correlation with the 6MWT or the PVAS.

Spearman'sCorrelationPain VASCMASMMT8PaVASPVAS6MWTCHAQ
Parent FSCorrelation-.632**.222.286-.427**-.029.129-.406**
 Sig (2-tailed).000.162.060.006.868.490.008
Child FSCorrelation-.648**.087.144-.445**.029.137-.411**
 Sig (2-tailed).000.577.363.005.876.478.009
Parent FVASCorrelation.550**-.303-.313*.280.110-.280.417**
 Sig (2-tailed).000.057.041.085.537.134.007
Child FVASCorrelation.535**-.304*-.415**.311.004-.324.545**
 Sig (2-tailed).000.044.006.054.984.086.000

Conclusions:

It appears that the PedsQL FS does not fully objectively measure fatigue but combined with the FVAS may be a reasonable tool for assessing fatigue in JDM. However it is also recognised that psychological and psychosocial factors also play a role in patient self reported fatigue and further research is required into this area.

To cite this abstract, please use the following information:
Maillard, Susan M., Todd, Amy, Nistala, Kiran, Pilkington, Clarissa, Hassan, Abdul; To Explore the Use of the PedsQL Subjective Questionnaire To Assess Levels of Fatigue in Children with Juvenile Dermatomyositis. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :1344
DOI: 10.1002/art.29110

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