Fatigue and spinal cord injury: a qualitative analysis

Abstract

Objectives: To explore experiences of fatigue among people with spinal cord injuries (SCIs) and factors perceived to contribute to fatigue. Setting: Kelowna, Prince George, Vancouver and Victoria, British Columbia, Canada. Study design: Collaborative, qualitative methodology. Methods: Four focus groups were undertaken simultaneously with a total of 29 participants, comprising a purposive sample of men and women: 21 people with complete and incomplete SCI of high and low tetraplegia and paraplegia, 2 family members, 2 assistants and 4 occupational therapists. Interpretive analysis was grounded in the themes identified in the data. Results: Fatigue was perceived to have cognitive, emotional and physical dimensions and to exert a profound effect on the lives of many people with SCI, such that pleasurable activities were often eschewed to enable the accomplishment of more mundane tasks. Factors most consistently associated with fatigue were pain, depression and hopelessness, side effects of medications, poor quality sleep, spasticity, poor posture, diet, and the effort required to accomplish routine and self-care tasks. Conclusions: Fatigue is a complex phenomenon, interlinked with pain, depression and hopelessness that significantly diminishes the quality of life following SCI. Further research is required to provide greater understanding of this issue and to determine appropriate and comprehensive forms of intervention.

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

“…2,9 There is however a challenge to determine whether depression is a contributor to fatigue or vice versa. 2,9 In a qualitative study by Hammell et al, 12 focus group interviews elucidated pain, depression and hopelessness, side effects of medications, poor quality of sleep, spasticity, poor posture, diet, and the effort required to accomplish routine and self-care tasks to be associated with fatigue.…”

Secondary complications and subjective well-being in individuals with chronic spinal cord injury: associations with self-reported adiposity

“…3 In addition to chronic diseases, individuals with SCI report myriad injury-related comorbidities and complications, including bladder problems, pressure sores, pain, spasticity and fatigue. 4,5 Nearly 95% of individuals with SCI currently have at least one secondary complication, whereas the majority of these individuals (58%) have three or more complications. 4 However, little is know about the relationship between elevated adiposity (that is, body fatness and overweight) and the secondary complications frequently experienced by individuals with SCI.…”

Fatigue level in spinal cord injury AIS D community ambulatory subjects

“…[3][4][5][6] However, there are few studies about fatigue in the SCI population. 1,[7][8][9][10] Furthermore, fatigue in SCI has been correlated with other clinical symptoms such as pain, depression 1,2,[8][9][10] and the effect of medication. 10 Pain is one of the most frequent factors related to fatigue in literature.…”

“…10 Pain is one of the most frequent factors related to fatigue in literature. 2,6,8,9 Depression is a very common symptom that also contributes to higher levels of perceived fatigue. 9,11 A relationship was described among SCI wheelchair users and fatigue, describing that the higher the physical activity, the lower the fatigue severity scale (FSS) scale.…”