THE IMPACT OF FATIGUE AND WALKING CAPACITY ON QUALITY OF LIFE IN PATIENTS WITH MULTIPLE SCLEROSIS

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Abstract
OBJECTIVE: This study aimed to evaluate the independent and combined effects of fatigue and walking impairment on multiple sclerosis (MS)-specific quality of life (QoL) and to explore the influence of sociodemographic and clinical factors on these associations.MATERIAL AND METHODS: A multicenter, cross-sectional study was conducted including 181 individuals with MS from four tertiary care centers in Turkey. Patients completed the Fatigue Severity Scale (FSS), the 12-item MS Walking Scale (MSWS-12), and the Multiple Sclerosis Impact Scale (MSIS-29). Sociodemographic and clinical data were collected. Correlation analyses, subgroup comparisons, and multivariate linear regressions were performed to identify predictors of QoL.RESULTS: MSIS-29 scores were strongly associated with MSWS-12 (r=0.81) and moderately associated with FSS (r=0.54) (p<0.001 for both). Multivariate regression demonstrated that walking impairment (β=0.772) and fatigue (β=0.179) were independent predictors of QoL, jointly explaining 70% of the variance in MSIS-29 total scores (R²=0.703). MSWS-12 was the primary predictor of physical QoL, while both MSWS-12 and FSS contributed to psychological QoL. Lower education and comorbidities were associated with worse outcomes in univariate analyses, and female sex was associated with greater disease impact in the multivariable model.CONCLUSIONS: Fatigue and walking limitations are major determinants of reduced QoL in MS, with walking impairment exerting a stronger effect on physical functioning. These results highlight the importance of multidimensional care strategies that address both motor and non-motor symptoms, alongside sociodemographic and clinical characteristics, to optimize individualized MS management.

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