The Correlation Between Static Fatigue Testing and the Quantitative Myasthenia Gravis Score and Activities of Daily Living Profile


  • Navdeep Lail, MD Dept. of Neurology, Univ. at Buffalo Jacobs School of Medicine and Biomedical Sciences, SUNY
  • Gil Wolfe, MD Dept. of Neurology, Univ. at Buffalo/SUNY
  • Laura Herbelin, BS Dept. of Neurology, Univ. of Texas Southwestern Medical Center
  • Sharon Nations, MD Dept. of Neurology, Univ. of Texas Southwestern Medical Center
  • Barbara Foster, PhD
  • Nicholas Silvestri, MD
  • Richard J. Barohn, MD University of Missouri



myasthenia gravis, fatigue, disease outcomes


Fatigue is a common symptom in myasthenia gravis (MG), but both objective and subjective measures of fatigue are poorly studied in the disease.  We conducted a pilot study of static fatigue testing (SFT) in a group of MG patients, using an isometric quantified muscle analysis computer system.  Results from sustained isometric contraction of 5 muscle groups in 77 patients were correlated to the Quantitative MG Score (QMG) and the Activities of Daily Living Profile (MG-ADL), two commonly used outcome measures.  Pearson correlation coefficients for the SFT were highest (0.33) for hand grip for both the QMG and MG-ADL.  Correlations were quite poor for the proximal muscle groups and ankle dorsiflexion.  More work is needed to develop objective and subjective measures of fatigue in MG.   


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Sharma KR, Kent-Braun JA, Majumdar S, Huang Y, Mynhier M, Weiner MW, Miller RG. Physiology of fatigue in amyotrophic lateral sclerosis. Neurology 1995;45:733-740.

Djaldetti R, Ziv I, Achiron A, Melamed E. Fatigue in multiple sclerosis compared with chronic fatigue syndrome: A quantitative assessment. Neurology 1996;46:632-635.

Barohn RJ, McIntire D, Herbelin L, Wolfe GI, Nations S, Bryan W. Reliability testing of the quantitative myasthenia gravis score. Ann NY Acad Sci 1998;841:769-772.

Wolfe GI, Herbelin LL, Nations SP, et al. Myasthenia Gravis Activity of Daily Living Profile. Neurology 1999;52:1487-1489.

Andres PL, Hedlund W, Finison L, Conlon T, Felmus M, et al. Quantitative motor assessment in amyotrophic lateral sclerosis. Neurology 1986;36:937-941,

Ringel SP, Murphy JR, Alderson MK, Bryan W, England JD, et al. The natural history of amyotrophic lateral sclerosis. Neurology 1993;43:1316-1322.

Learmonth YC, Dlugonski D, Pilutti LA, Sandroff BM, Klaren R, Motl RW. Psychometric properties of the Fatigue Severity Scale and the Modified Fatigue Impact Scale. J Neurol Sci 2013;331:102-107.

Herlofson K, Larsen JP. Measuring fatigue in patients with Parkinson's disease - the Fatigue Severity Scale. Eur J Neurol 2002;9:595-600.

Werlauff U, Højberg A, Firla-Holme R, Steffensen BF, Vissing J. Fatigue in patients with spinal muscular atrophy type II and congenital myopathies: evaluation of the fatigue severity scale. Qual Life Res 2014;23:1479-88.

Burns TM, Sadjadi R, Utsugisawa K, et al. International clinimetric evaluation of the MG-QOL15, resulting in slight revision and subsequent validation of the MG-QOL15R. Muscle Nerve 2016;54:1015-1022.






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