With multiple sclerosis fatigue, a day is not organised well simply by counting how many activities you manage to do. It also helps to look at how much effort it takes to get ready, change position and start again after a break. A seven-day diary can make these steps visible and help you talk about them with the professionals. It does not measure how the disease is progressing and does not prescribe rest: it is a way of recognising where organising things differently, a support or an electric adjustment could make the routine less demanding.
In brief
In multiple sclerosis (MS), fatigue can vary during the day and can also affect small steps, such as reaching the handset or adjusting a support. The seven-day diary helps to connect the activities you want to do, breaks and the difficulties observed, without measuring the symptom clinically. Electric adjustments can make some changes of position less demanding, but they do not treat fatigue: the point of reference remains the person’s experience and the agreed care pathway.
Multiple sclerosis fatigue: why start from the day as it really is
The Italian Multiple Sclerosis Society (AISM) describes fatigue as a physical or mental experience that can be out of proportion to the activity and not visible from the outside. The time of day also varies: not everyone feels better in the morning or worse in the evening. Automatically attributing the problem to laziness or lack of effort is therefore misleading. [1]
For a family, this means not judging the whole week by one demonstration that went well: “yesterday they managed to get up” does not necessarily describe what happens today. It is more useful to ask which steps require help, at what time of day and with what consequence for the activities that follow.
The aim of the diary is not to do more at all costs. It might be managing to phone a friend without having used up your energy getting settled, or stopping reading and picking it up again whenever you wish. The question becomes: which part of the routine would I like to make less tiring?
Seven days of observation, not seven days of exercises
The AISM guide “So Tiring!” suggests recording activity, time, perceived fatigue and comments in order to understand the symptom better. [2] The sheet below narrows the observation down to changes of position and breaks: it is a Sollevita editorial adaptation, not a diagnostic questionnaire and not a reproduction of a validated scale.
Choose a reasonably representative week, without waiting for the perfect one. Record a few significant episodes, instead of turning every movement into a task to write down. You can write, dictate a note or ask a family member to put your words on paper.
Do not change medication, exercises or care instructions to make the days comparable. If a day is different from usual, note it in the diary: an appointment, a commitment away from home or a restless night help to describe the context, without attributing a cause to the symptom on your own.
Record-keeping should stay light. If filling it in becomes an extra effort, a single sentence is enough: “I wanted to rest, but I needed help to position my legs and the handset.” That is already more informative than a generic “difficult day”.
The weekly summary
Use one row per day for the episode you want to remember. For other episodes you can add a free note with the same fields.
| Day and time | Activity or change of position | Perceived fatigue and help needed | Break chosen and what you noticed afterwards |
|---|---|---|---|
| 1 · ______ | __________________ | __________________ | __________________ |
| 2 · ______ | __________________ | __________________ | __________________ |
| 3 · ______ | __________________ | __________________ | __________________ |
| 4 · ______ | __________________ | __________________ | __________________ |
| 5 · ______ | __________________ | __________________ | __________________ |
| 6 · ______ | __________________ | __________________ | __________________ |
| 7 · ______ | __________________ | __________________ | __________________ |
Use words you recognise: “manageable”, “demanding”, “I stopped”. There is no need to give a score. In the last column, note what you were able to do afterwards, or whether the break did not change the situation. Seeing no difference is useful information, not a wrong result.
How much effort it takes to get ready and change position
Reading can be enjoyable, while getting settled to read takes several attempts. Or resting is comfortable, but getting back to the seated position requires help to retrieve the remote control. Separating the activity from the preparation lets you understand which difficulty you are really trying to tackle.
In the diary you can distinguish three moments: getting into the position, staying in it and getting out of it. Write down when the arms come into play, when someone needs to be called and whether the person can operate the return themselves. This is not about timing a performance: what counts are the steps that interrupt the person’s own control of the situation.
A chair with electric adjustments can move the backrest and footrest without requiring the person to operate a lever or lift the support by hand. This does not mean, however, that it can, on its own, reposition a pelvis that has slid forward or compensate for any postural difficulty.
Drawing this line avoids attributing to the motors a task they do not perform. In Sollevita’s functions for rest and changes of position you can see what moves and link it to the episode you recorded, without choosing on the basis of the number of functions. [4]
Organising breaks without turning them into a rigid timetable
AISM points out the value of recognising the signs of tiredness, spreading activities out and alternating effort and rest before your energy runs out. [1] This principle does not mean prescribing the same break for everyone or imposing a fixed number of minutes in the chair.
After a few days, compare similar episodes. Perhaps preparing lunch and tidying the room straight away leaves little room for a conversation; perhaps it is above all the constant moving between surfaces that requires help. The diary helps you put a precise question to the professional: “which part can we organise differently?”
You can note what you want to keep, delegate or spread out. An important phone call does not have to disappear automatically because it requires energy. On the contrary, minor preparations of little importance could be simplified to leave room for the activity the person has chosen.
Avoiding unnecessary effort does not mean giving up appropriate movement. Activity and rehabilitation should be maintained according to the individual plan. AISM stresses that goals and interventions are built together with the person and must be adapted when needs change. [5]
Recline, tilt-in-space and 180° lie-flat position: choose the break you need
For a short break, a change to the backrest or to the leg support may be enough. There is no need to reach full recline just because it is available. The diary can distinguish “I changed how I was supported” from “I wanted to lie down”: they are different requests.
Tilt-in-space tilts the seat and backrest together. Recline, on the other hand, changes the angle of the backrest relative to the seat. Zero Gravity combines several adjustments for a position with the legs and feet raised; the 180° lie-flat position allows a fully extended configuration. These are comfort options, not treatments for fatigue or spasticity. [4]
Sollevita integrates a minimum of 5 and up to 8 independent motors, according to the weight capacity. The adjustments make it possible to choose a position suited to the break and to return to the seated position when needed. The sequence of controls should be learned on the configuration delivered, taking the person’s own preferences into account. [4]
If a position requires constant adjustments or is not tolerated, do not insist on reaching it. Write down what you observed and discuss it with the person’s care team. A break in the chair does not replace the bed, specialist supports or the instructions already in place when these are needed.
Measurements and remote control: two checks not to leave until last
Sollevita seats are available in a width of 52 or 63 cm, with three depths. Depth should be matched to thigh length and the supports, not deduced from height alone. A high backrest, the Push Head powered headrest and the footrest extension complete the support options; the three-layer seat construction combines a sprung seat base, individually pocketed springs and a comfort top layer. [4]
When observing in practice, ask yourself: is the back supported? Do the feet have the intended support in the position being used? Does the remote control stay within reach after reclining? These are more useful questions than “is the chair soft enough?”.
An adjustment that is available but difficult to use may require assistance every time. Check the remote control with the hand the person usually uses, without asking for prolonged trials when the person is already tired. If use becomes difficult, this should be taken into account in the plan, not interpreted as a lack of willpower.
AISM recommends assessing an assistive aid in relation to the person’s abilities, expectations, environment and the people involved; learning and follow-up checks are also part of the choice. [3] This is why the diary should record both what the person can do and the help they want or need.
How to read the diary without attributing every change to the chair
Imagine this illustrative example: on one day the person has to ask three times for the supports to be adjusted before reading; on another, they find the remote control close at hand and adjust the backrest themselves. The useful information is the different organisation of that action. It does not show that the chair has reduced the fatigue caused by the disease.
In the same way, an easier day may coincide with a different schedule of activities. Do not compare two days as if they were a clinical trial. Look instead for patterns that repeat: is the remote control often out of reach? Is the transfer for every break really necessary? Is the desired position reached, or does it require constant adjustments?
At the end of the week, write down three conclusions: the activity to preserve, the most demanding step and the question to address. This is enough to move from a generic request to a concrete conversation, without turning the person into a set of measurements.
When the diary helps and when you should not wait
The sheet is useful for describing a routine, preparing for the consultation or checking how an aid already chosen is being used. There is no need to wait seven days when fatigue changes markedly, a new symptom appears or a difficulty requires a medical assessment. Fatigue can also have associated factors, such as sleep, infections or medication, which adjusting a chair will not clear up. [1]
Nor should you wait for the sheet to be complete before asking for support with a remote control that is hard to use or a support that is unsuitable. You can bring partial observations. The healthcare professional assesses the symptom and the personal plan; the Sollevita Team clarifies the product’s functions, measurements and technical options.
The mistakes to avoid are few but important: using the break as a reward after becoming exhausted, attributing every difficulty to the same cause, choosing the seat on width alone and treating a relax position as a therapy. The diary is there to raise questions, not to close them with automatic explanations.
FAQ
Common questions
How can a diary help with multiple sclerosis fatigue?
It can make your account of activities, breaks and the help needed more precise. The suggested sheet looks above all at changes of position: it does not give a diagnosis, does not measure the severity of the disease and does not replace the questionnaires used by professionals.
Do I have to fill in every row for seven consecutive days?
No. Seven days is a suggested organisational window, not a medical requirement. A few well-described episodes are already useful. You can use voice notes or get someone to help you, without turning filling it in into another tiring task.
Can an electric riser recliner eliminate fatigue?
No. It can perform some of the mechanical movements needed to change how the body is supported or the angle of the chair. The possible benefit concerns those concrete actions, not the treatment of multiple sclerosis fatigue. Managing the symptom remains an individual matter. [1, 4]
Should I always use Zero Gravity during breaks?
No. An intermediate position may be enough; at other times the person prefers to lie down. The choice depends on comfort, supports and individual guidance. The availability of a function is not a prescription to use it.
Can the 180° lie-flat position also be useful for people who can walk?
Yes, when it allows a lying-down break in the usual spot and the person manages its use appropriately. It should not become a reason to reduce the recommended movement, nor should it automatically replace the bed.
What should I bring to the consultation after the diary?
Bring the three main observations, height and weight, the measurements of your current seat if available, and information on aids and the help you usually receive. For the technical side, photos of the rooms and information on which hand is used to operate the controls are also useful.
Reference sources
[1] AISM (Italian Multiple Sclerosis Society), Symptoms of multiple sclerosis: fatigue (in Italian). Characteristics of the symptom, variability and individual management. Open the source
[2] AISM, So Tiring! (in Italian), pp. 4–5. Diary and energy management; the sheet in this article is a separate adaptation. Open the source
[3] AISM, Multiple sclerosis: assistive aids (in Italian). Assessment of the person, the environment, use and follow-up checks over time. Open the source
[4] Sollevita, riser recliner chair with integrated care features: movements, measurements and construction. Open the source
[5] AISM, The individual rehabilitation plan (in Italian). Shared goals and adaptation of interventions. Open the source
Bring your real week to the consultation, not an ideal day
On the page Sollevita for needs related to multiple sclerosis you will find the overall picture of the product in this situation. Use the diary to choose, together with the Sollevita Team, which changes of position and which supports to check, while keeping the focus on the activities you want to continue doing.
