Fatigue is a major issue for children and adolescents with physical disabilities

Abstract

ABBREVIATIONS MVPAModerate to vigorous physical activity SES Socio-economic status AIM This study aimed to investigate fatigue, and its correlates, in children and adolescents with physical disabilities.METHOD Sixty-five young people aged 8 to 17 years (35 males, 30 females; mean age 13y 2mo, SD 2y 8mo) with mild to moderate physical disabilities (Gillette Functional Assessment Questionnaire levels 7-10) were recruited. Self-reported fatigue was measured using the PedsQL Multidimensional Fatigue Scale. Physical activity was measured using 7-day hipworn accelerometer. Associations between fatigue, physical activity, and socio-demographic characteristics were examined using analysis of covariance, with significance (a) set at 0.05.Results were compared with normative data from other paediatric populations.

Fatigue in young people with Duchenne muscular dystrophy

“…25 In a crosssectional study of adults with DMD, fatigue and affective disorders coexisted in 24% of patients. 29 It is possible that the PAQ-C/A did not adequately capture variability in physical activity level of males with DMD, reducing the magnitude of association between physical activity level and fatigue. Distinguishing fatigue from sleep disturbance symptoms and depressive symptoms, and understanding causal relationships of this triad is essential for developing targeted therapeutic strategies to achieve satisfactory outcomes.…”

Factors associated with fatigue in children with perinatal stroke

“…1,2 The study by Wrightson et al 3 is the first to examine the correlates of fatigue in children with hemiparetic perinatal stroke. The survivors must cope with a wide array of sequelae, including deficits in motor and cognitive functioning, epilepsy, and psychological and behavioral challenges.…”

Time to take notice: what about fatigue?

“…2 Fatigue is not unique to children; adults with spastic diplegic CP report significantly higher levels of fatigue and pain than unaffected adults. 3 Maher et al 4 are the first to describe self-reported fatigue in ambulatory children with physical disabilities, so that comparisons can be made with typically developing children and children with other chronic health conditions. By documenting that fatigue levels in a diverse group of young people with physical disabilities are similar to levels in young people with cancer, this study argues that it is time to pay attention to fatigue in children with physical disabilities, and to address this fatigue directly or indirectly by modifying pain, sleep, or physical activity.…”

“…Future work should examine how pain influences fatigue levels, expanding on the covariates examined by Maher et al 4 It is time to give the influence of fatigue the attention it requires with regard to the care of children with physical disabilities. To paraphrase Terrance Edgar, MD, fatigue is a bit like love: it is internally mediated, but has emotional/physical effects with longterm consequences.…”

“…2 In a recent qualitative study, individuals with CP described difficulty with predicting and managing fatigue from activities of daily living such as walking. 3 When this is combined with other literature that demonstrates individuals with CP experience more fatigue than the general population, 4 the question that arises is: 'Do we know how active these individuals need to be in order to gain appropriate health benefits while mitigating the negative consequences of pain and fatigue?' This question remains unanswered, partially due to the fact that most activities of daily living for these individuals result in increased energy expenditure and effort.…”