Clinical correlates of fatigue in spinal cord injury

Abstract

Study design: Retrospective chart review. Objectives: To determine the prevalence of fatigue in an outpatient spinal cord injury population and to examine the clinical variables contributing to that fatigue. Setting: GF Strong Rehabilitation Centre, Vancouver, British Columbia, Canada. Methods: Medical charts of 76 individuals admitted to the GF Strong Outpatient SCI Program between December 2004 and December 2005 were reviewed. Data collected included information on clinical characteristics, demographics and Fatigue Severity Scale (FSS) scores. Multivariable analysis was completed to determine the independent association between these variables and fatigue severity. Results: A total of 57% (95% confidence interval (CI) ¼ 45-67%) of the sample were found to have fatigue severe enough to interfere with function. People that were admitted for medical reasons; had pain, spasticity, incomplete injuries, and/or were on more that one medication with a known side effect of fatigue had significantly higher FSS scores. Multivariable analysis indicated incomplete injury was the only statistically significant predictor of a higher FSS scores; pain approached significance (P ¼ 0.07, CI ¼ À0.09, 2.06). Together these variables account for 18% of the variance in FSS scores in this sample. Conclusion: Fatigue among individuals with spinal cord injury who are seeking outpatient rehabilitation is very common. The severity of fatigue was greater for individuals with incomplete lesions. Pain was also a potentially important covariate of fatigue. Further research is required to determine what else contributes to fatigue severity beyond these clinical variables as only minimal variance was accounted for in our model.

Fatigue in persons who have lived with spinal cord injury for >20 years

“…In previous studies, some of the above mentioned variables have shown relationships to fatigue. [8][9][10] As previously mentioned, the variability of findings among studies may be related to methodological differences, and need further clarification.…”

“…24 These variables were selected based on judgement and previous research. [8][9][10] Collinearity problems were indicated if the variance inflation factor for any covariate exceeded five, and by Spearman correlations. …”

“…4,5 Today, clinicians and researchers find that fatigue is a consequence that magnifies the physical challenges of SCI and diminishes the quality of life. [5][6][7] Fawkes-Kirby et al 8 found that fatigue was common among individuals with SCI who were seeking outpatient rehabilitation.…”

“…[8][9][10][11] It is known that depression is common after SCI, and previous reports have documented a relationship between depression and fatigue. 2,9 There is however a challenge to determine whether depression is a contributor to fatigue or vice versa.…”

Parameters for positive outcome of the in-hospital rehabilitation of spinal cord lesion patients: the Boberg Quality Score

“…2,1,[3][4][5][6][7] Other studies focus on the importance of related symptoms such as pain, psychosocial problems and loss of energy in the rehabilitation patient or the compliance of the patient is seen as a main outcome factor. [8][9][10][11][12][13][14][15][16][17] Studies researching the social reintegration mainly focus on occupational situation, living conditions and quality of life. [18][19][20][21][22][23][24] A multi-dimensionally measuring test device, internationally usable and applicable for inpatients as well as outpatients is thereby currently lacking.…”