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The article discusses the lack of diversity in behavioral intervention trials for multiple sclerosis (MS) and provides recommendations to address this issue. It focuses on the REFUEL-MS research program, which aims to develop a digital behavioral intervention for MS fatigue. The program actively engages with diverse communities through patient and public involvement groups, community outreach, and social media to ensure accessibility and acceptability. The authors emphasize the importance of involving diverse stakeholders and researchers to improve the diversity and inclusivity of MS research. [Extracted from the article]

Background: Researchers have attempted to operationalise objective measures of cognitive fatigability in multiple sclerosis (MS) to overcome the perceived subjectivity of patient-reported outcomes of fatigue (PROs). Measures of cognitive fatigability examine decrements in performance during sustained neurocognitive tasks. Objective: This personal viewpoint briefly summarises available evidence for measures of cognitive fatigability in MS and considers their overall utility. Results: Studies suggest there may be a construct that is distinct from self-reported fatigue, reflecting a new potential intervention target. However, assessments vary and findings across and within measures are inconsistent. Few measures have been guided by a coherent theory, and those identified are likely to be influenced by other confounds, such as cognitive impairment caused more directly by disease processes, depression and assessment biases. Conclusion: Future research may benefit from (a) developing a guiding theory of cognitive fatigability, (b) examining ecological and construct validity of existing assessments and (c) exploring whether the more promising cognitive fatigability measures are correlated with impaired functioning after accounting for possible confounds. Given the issues raised, we caution that our purposes as researchers may be better served by continuing our search for a more objective cognitive fatigability construct that runs in parallel with improving, rather than devaluing, current PROs. [ABSTRACT FROM AUTHOR]

Background: Fatigue is one of the most distressing symptoms of multiple sclerosis (MS). Measuring MS fatigue poses a number of challenges. Many measures confound definitions of severity and impact of fatigue and/or lack psychometric validation in MS. Objective: To evaluate the psychometric properties of an 11-item fatigue severity measure, the Chalder Fatigue Questionnaire (CFQ) in MS including validity of the factor structure, internal reliability, discriminant validity and sensitivity to change. Methods: Data were pooled from four previous studies investigating MS fatigue using the CFQ (n=444). Data analysis included confirmatory factor analysis to determine the factor structure and model fit, correlations to assess discriminant validity and effects sizes to determine sensitivity to change. Results: A bi-factor model with one general fatigue factor, incorporating two smaller group factors (mental and physical fatigue) had good model fit and appeared the most appropriate factor structure underlying the CFQ scale. The CFQ had high internal consistency, showed small to moderate correlations with impact of fatigue and mood, and was sensitive to change across low and high intensity behavioural interventions. Conclusions: The CFQ measuring a composite of physical and mental fatigue severity (i.e. a total score) is a psychometrically sound measure of fatigue severity in MS. [ABSTRACT FROM AUTHOR]

The article presents a study which aims to explore the experience and responses to pain of people with multiple sclerosis (pwMS) and their perspectives on pain management. It notes the semi-structured telephone interviews carried out using an inductive thematic analysis approach with elements of grounded theory. It concludes the identification of pain-related beliefs, emotional reactions and pain-management attitudes of pwMS that may rectify management choices and enhance pain acceptance.