The MFIS is a modified form of the Fatigue Impact Scale (Fisk et al., 1994) based on items derived from interviews with MS patients concerning how fatigue impacts their lives. This instrument provides an assessment of the effects of fatigue in terms of physical, cognitive, and psychosocial functioning.
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Abbreviated: 5
2-10 minutes
Approximately 5-10 minutes for the full-length version and 2-3 minutes for the abbreviated version.
Initially reviewed by Tammie Johnson, PT, DPT, MS and the TBI EDGE task force of the Neurology Section of the APTA in 9/2012.
Recommendations for use of the instrument from the Neurology Section of the American Physical Therapy Association’s Multiple Sclerosis Taskforce (MSEDGE), Parkinson’s Taskforce (PD EDGE), Spinal Cord Injury Taskforce (PD EDGE), Stroke Taskforce (StrokEDGE), Traumatic Brain Injury Taskforce (TBI EDGE), and Vestibular Taskforce (Vestibular EDGE) are listed below. These recommendations were developed by a panel of research and clinical experts using a modified Delphi process.
For detailed information about how recommendations were made, please visit:
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Abbreviations: |
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|
HR |
Highly Recommend |
|
R |
Recommend |
|
LS / UR |
Reasonable to use, but limited study in target group / Unable to Recommend |
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NR |
Not Recommended |
Recommendations for use based on acuity level of the patient:
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Acute (CVA < 2 months post) (SCI < 1 month post) (Vestibular < 6 weeks post) |
Subacute (CVA 2 to 6 months) (SCI 3 to 6 months) |
Chronic (> 6 months) |
|
StrokEDGE |
NR |
UR |
UR |
Recommendations based on level of care in which the assessment is taken:
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Acute Care |
Inpatient Rehabilitation |
Skilled Nursing Facility |
Outpatient Rehabilitation |
Home Health |
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MS EDGE |
R |
R |
R |
R |
R |
|
StrokEDGE |
NR |
NR |
UR |
UR |
UR |
|
TBI EDGE |
NR |
LS |
LS |
LS |
LS |
Recommendations for use based on ambulatory status after brain injury:
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Completely Independent |
Mildly dependant |
Moderately Dependant |
Severely Dependant |
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TBI EDGE |
N/A |
N/A |
N/A |
N/A |
Recommendations based on EDSS Classification:
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EDSS 0.0 – 3.5 |
EDSS 4.0 – 5.5 |
EDSS 6.0 – 7.5 |
EDSS 8.0 – 9.5 |
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MS EDGE |
R |
R |
R |
NR |
Recommendations for entry-level physical therapy education and use in research:
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Students should learn to administer this tool? (Y/N) |
Students should be exposed to tool? (Y/N) |
Appropriate for use in intervention research studies? (Y/N) |
Is additional research warranted for this tool (Y/N) |
|
MS EDGE |
No |
Yes |
Yes |
No |
|
StrokEDGE |
No |
No |
Yes |
Not reported |
|
TBI EDGE |
No |
No |
No |
Not reported |
Do you see an error or have a suggestion for this instrument summary? Please e-mail us!
Multiple Sclerosis: (Rietberg, 2010; n= 43; ambulatory patients with MS (mean age 48.7 years; SD 7 years; 30 women; median Expanded Disability Status Scale score 3.5)
Multiple Sclerosis: (Tellez et al, 2005; 231 MS patients and 123 healthy controls, 164 patients with relapsing-remitting, 47 with secondary progressive, 12 with primary progressive)
Multiple Sclerosis: (Rietberg, 2010; n= 43; ambulatory patients with MS (mean age 48.7 years; SD 7 years; 30 women; median Expanded Disability Status Scale score 3.5)
Multiple Sclerosis: (Amtmann et al, 2012; n=1271 individuals with MS living in the community, 80% female, 36.2% reported being employed 20 or more hours a week; mean age 50.7, mean disease duration 13.2 years, MS severity as minimal (EDSS≤4.0) for 32.4% and intermediate (EDSS 4.5-6.5) for 47.9% and advanced (EDSS≥7.0) for 19.7%)
Multiple Sclerosis: (Kos et al, 2005)
Concurrent validity:
Multiple Sclerosis: (Rietberg, 2010; n= 43; ambulatory patients with MS; mean age 48.7 years; SD 7 years; 30 women; median Expanded Disability Status Scale score 3.5)
Multiple Sclerosis: (Tellez et al, 2005; (231 MS patients and 123 healthy controls, 164 patients with relapsing-remitting, 47 with secondary progressive, 12 with primary progressive)
Multiple Sclerosis: (Mills et al, 2010; n=415)
Multiple Sclerosis: (Amtmann et al., 2012; n=1271 individuals with MS living in the community, 80% female, 36.2% reported being employed 20 or more hours a week. Mean age 507, mean disease duration 13.2 years, MS severity as minimal (EDSS≤4.0) for 32.4% and intermediate (EDSS 4.5-6.5) for 47.9% and advanced (EDSS≥7.0) for 19.7%)
Multiple Sclerosis: (Amtmann et al., 2012; n=1271 individuals with MS living in the community, 80% female, 36.2% reported being employed 20 or more hours a week; mean age 50.7, mean disease duration 13.2 years, MS severity as minimal (EDSS≤4.0) for 32.4% and intermediate (EDSS 4.5-6.5) for 47.9% and advanced (EDSS≥7.0) for 19.7%)
Traumatic Brain Injury: (Sendroy-Terrill et al., 2010, n=243, 73% men, less than 5% of participants unconsciousness of < 1 day, 41 % showed LOC 1 day to 1 week, 31 % LOC from 1 week to 1 month, 24% had LOCs from 1 month to 1 year. Recived treatment in a comprehensive inpatient rehabilitation hospital. Cohorts based on years postinjury (1 to >30 years))
Mean for total MFIS= 23.7±21.1
Mean for MFIS - Physical= 10.2±9.6
Mean for MFIS - Cognitive=11.4±10.4
Mean for MFIS - Psychosocial= 2.0±2.0
Predictive Validity:
Traumatic Brain Injury: (Sendroy-Terrill et al., 2010, n=243, 73% men, less than 5% of participants unconsciousness of < 1 day, 41 % showed LOC 1 day to 1 week, 31 % LOC from 1 week to 1 month, 24% had LOCs from 1 month to 1 year. Recived treatment in a comprehensive inpatient rehabilitation hospital. Cohorts based on years postinjury (1 to >30 years))
Amtmann, D., Bamer, A. M., et al. (2012). "Comparison of the psychometric properties of two fatigue scales in multiple sclerosis." Rehabil Psychol 57(2): 159-166.
Belmont, A., Agar, N., et al. (2006). "Fatigue and traumatic brain injury." Ann Readapt Med Phys 49(6): 283-288, 370-284.
Fisk, J. D., Ritvo, P. G., et al. (1994). "Measuring the functional impact of fatigue: initial validation of the fatigue impact scale." Clin Infect Dis 18 Suppl 1: S79-83.
Kos, D., Kerckhofs, E., et al. (2005). "Evaluation of the Modified Fatigue Impact Scale in four different European countries." Mult Scler 11(1): 76-80.
Mills, R. J., Young, C. A., et al. (2010). "Rasch analysis of the Modified Fatigue Impact Scale (MFIS) in multiple sclerosis." J Neurol Neurosurg Psychiatry 81(9): 1049-1051.
Ponsford, J. L., Ziino, C., et al. (2012). "Fatigue and sleep disturbance following traumatic brain injury--their nature, causes, and potential treatments." J Head Trauma Rehabil 27(3): 224-233.
Rietberg, M. B., Van Wegen, E. E., et al. (2010). "Measuring fatigue in patients with multiple sclerosis: reproducibility, responsiveness and concurrent validity of three Dutch self-report questionnaires." Disabil Rehabil 32(22): 1870-1876.
Sendroy-Terrill, M., Whiteneck, G. G., et al. (2010). "Aging with traumatic brain injury: cross-sectional follow-up of people receiving inpatient rehabilitation over more than 3 decades." Arch Phys Med Rehabil 91(3): 489-497.
Tellez, N., Rio, J., et al. (2005). "Does the Modified Fatigue Impact Scale offer a more comprehensive assessment of fatigue in MS?" Mult Scler 11(2): 198-202.
We have reviewed more than 500 instruments for use with a number of diagnoses including stroke, spinal cord injury and traumatic brain injury among several others.