Beyond pain in fibromyalgia: insights into the symptom of fatigue

Table 2 Symptom assessment in the clinical setting

Symptom	Sample assessment tools	Conditions to consider	Objective tests
Activity intolerance	BPI pain interference [53]	Deconditioning	6 minute walk test
	MFI reduced activity [54]	Obesity	Cardiopulmonary exercise test
	MFI reduced activity [54]	Obesity	30-second chair-stand test
	SF-36 role emotional, role physical [55, 56]	Neuromuscular disorder	Body mass index
Affective	GAD-7 [57]	Anxiety disorder
	PHQ-9 [58]	Generalized anxiety disorder
	HADS [59]	Depression
	CES-D [60]	Dysthymia
	CES-D [60]	Somatoform disorder
Autonomic	ASP-31 [61]	Orthostatic intolerance	Thermoregulatory sweat test
		Autonomic neuropathies	Autonomic reflex screen
		Postural orthostatic tachycardia syndrome	Autonomic reflex screen
Pain	BPI [53]	Regional pain syndromes	Imaging
	Pain VAS	Neuropathy	Electromyography
		Inflammatory arthritis	Laboratory testing for inflammation
		Degenerative arthritis	Muscle biopsy
		Headaches	Quantitative sensory testing
		Myopathy	Quantitative sensory testing
Unrefreshing sleep	MOS-Sleep [62]	Insomnia	Overnight oximetry
	Berlin Sleep Questionnaire	Obstructive sleep apnea	Polysomnography
	Restless legs screen	Restless legs syndrome	Actigraphy
		Periodic limb movement disorder
		Narcolepsy
		Sleep phase disorder

ASP-31, Autonomic Symptom Profile-31; BPI, Brief Pain Inventory; CES-D, Center for Epidemiologic Studies Depression Scale; GAD-7, Generalized Anxiety Disorder questionnaire; HADS, Hospital Anxiety and Depression Scale; MFI, Multidimensional Fatigue Inventory; MOS-Sleep, Medical Outcomes Study Sleep Scale; PHQ-9, Patient Health Questionnaire; SF-36, Medical Outcomes Study Short Form-36; VAS, Visual Analogue Scale.

ISSN: 1478-6362