Physical activity is related to lower levels of pain, fatigue and depression in individuals with spinal-cord injury: a correlational study

Tawashy, Amira; Eng, Janice J.; Lin, Kwan-Hwa; Tang, Pei-Fang; Hung, Chihya

doi:10.1038/sc.2008.120

Cited by 124 publications

(90 citation statements)

References 23 publications

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“…20 Our finding is consistent with that of a previous study that showed that less exercise was related to more fatigue 5 and heavy intensity activity was related to lower fatigue in persons with chronic SCI. 12 However, we found no relationship between fatigue and physical behavior in our study. Therefore, we could not confirm the fatigue, physical fitness and physical behavior cycle hypothesis proposed by Durstine et al 6 However, our physical behavior measurement was limited to outcomes on postures, wheeled physical activity and mean motility of trunk and arms.…”

Section: Discussioncontrasting

confidence: 54%

“…In persons with SCI in the chronic phase, fatigue has been shown to relate to age 10 and lesion characteristics. 4 With regard to physical factors, being overweight has been found to negatively impact fatigue, 11 and physical activity that requires a lot of physical effort 12 is related to less fatigue in persons with SCI in the chronic phase.…”

Section: Introductionmentioning

confidence: 99%

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Fatigue in persons with subacute spinal cord injury who are dependent on a manual wheelchair

et al. 2015

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Study design: Cross-sectional. Objectives: To determine the prevalence and severity of fatigue in persons with subacute spinal cord injury (SCI), assess whether demographic and lesion characteristics are related to fatigue and determine the relationship with physical fitness and physical behavior. Setting: Measurements were performed 2 months before discharge from inpatient rehabilitation. Methods: Thirty-six persons with subacute SCI, dependent on a manual wheelchair, mean age 43 ± 15 and 83% men, completed the Fatigue Severity Scale (FSS). FSS scores 44 indicated fatigue. We recorded age and lesion characteristics, measured body mass index, measured peak power output and peak oxygen uptake during a maximal handcycling test and determined physical behavior using an accelerometer-based activity monitor. T-tests were used to test for differences in fatigue between subgroups based on age and lesion characteristics, and regression analyses to assess the relationship with physical fitness and physical behavior. Results: Mean FSS was 3.3 ± 1.3. Fatigue, including severe fatigue, was prevalent in 31% (95% confidence interval: 16-46) of participants compared with 18% in the general population. Furthermore, mean fatigue was significantly higher in persons with incomplete compared with complete lesions (t = 2.22, P = 0.03). Mean scores between other subgroups did not differ significantly. Of the physical fitness and physical behavior measures, only peak oxygen uptake tended to be related to more fatigue (B = − 1.47, P = 0.05). Conclusion: Fatigue was prevalent and is of concern in persons with subacute SCI. Those with incomplete lesions seem to be at higher risk. Because fatigue is known to persist among persons with SCI, interventions to reduce fatigue seem necessary.

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Section: Discussioncontrasting

confidence: 54%

Section: Introductionmentioning

confidence: 99%

Fatigue in persons with subacute spinal cord injury who are dependent on a manual wheelchair

et al. 2015

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“…3 Although there are few estimates of the prevalence of fatigue in SCI, there is evidence to suggest that this is a common concern. [1][2][3][4][5][6] In fact, a study of an outpatient sample of individuals with SCI reported that 57% experienced fatigue, which interfered with daily function. 7 The experience of fatigue was found to be exacerbated by other factors (for example, spasticity, completeness of injury, medication use).…”

Section: Introductionmentioning

confidence: 99%

“…10 This paindepression-fatigue triad is commonly reported clinically and in the literature as a complex multifactorial relationship that impacts function for individuals after SCI 11 and has been demonstrated to be associated with factors such as physical activity. 5 Pain 8 and depression 12 have each been shown to be associated with participation in community activities, an outcome recognized for its relationship to overall health 13 and quality of life. 14 The relationships between factors are complex, and, it is clear it would be difficult to consider the association between participation and a single factor (that is, fatigue), without considering the influence of related factors.…”

Section: Introductionmentioning

confidence: 99%

The relationship between fatigue and participation in spinal cord injury

et al. 2015

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Study design: Cross-sectional national survey. Objectives: To explore the association between fatigue and community participation frequency and provide an adjusted model of the relationship including important covariates. Setting: Canada; Community. Methods: Data were obtained from the Rick Hansen Spinal Cord Injury Registry Community Survey. We used multi-variable regression analyses with hierarchical backward elimination, including variable specification, interaction assessment and confounding assessment. Variables with statistically significant correlation with the primary-dependent variable (participation) were included for modeling.Results: The crude model of association between fatigue and participation accounted for 7.2% of the variance in participation scores. The full model with all a priori selected variables accounted for 25.1% of variance in participation scores. The adjusted model, including the identified confounders (pain, depressive mood, comorbidities and level of injury), accounted for 21.1% of variance in participation scores. Depressive mood variables had the highest standardized beta coefficients, reflecting the largest contribution to this model. Conclusion: Fatigue has a statistically significant negative association with participation for individuals with spinal cord injury, when controlling for pain, depressive mood, comorbidities and level of injury. Multifaceted clinical interventions and research addressing fatigue, pain and depressive symptoms are warranted.

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“…8 In addition, pain has been shown to directly interfere with sensorimotor functions, such as the capacity to learn locomotor 9 and upper limb motor 10 tasks. As such, simultaneous treatment of motor functions and pain would be preferred over conventional treatment, that is suboptimal as evidenced by the high prevalence of chronic pain.…”

Section: Introductionmentioning

confidence: 99%

Virtual feedback for motor and pain rehabilitation after spinal cord injury

Roosink

Mercier

2014

Spinal Cord

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Study design: Interventions using virtual feedback (VF) impact on motor functions and pain and may be relevant for neurorehabilitation after spinal cord injury (SCI) in which motor dysfunctions and (concomitant) pain are frequently observed. Potential mechanisms underlying VF include a modulation of cortical sensorimotor integration, increased therapy engagement and distraction from effort and pain. Still, the optimal parameters for VF and their technical implementation are currently unknown. Objectives: To provide an overview of interventions that have used VF to improve motor functions or to reduce pain after SCI. Methods: Literature review. Results: A total number of 17 studies were identified. VF interventions commonly focused on improving motor functions (n = 12) or reducing pain (n = 4). Only one study assessed both motor functions and pain. Studies generally report beneficial effects. However, the evidence is of low-level quality and many practical as well as theoretical issues remain unclear. Remaining knowledge gaps include: (1) optimal VF system characteristics, (2) the impact of different VF modalities and tasks, (3) dose-response relationships and (4) the identification of patients that are likely to benefit from VF. Future work should start by closing these knowledge gaps using systematic and controlled multi-session interventions and by assessing the underlying mechanisms involved. Conclusion: These results provide an important incentive to further assess the potential of VF interventions to simultaneously improve motor functions and reduce pain after SCI, which could contribute to better neurorehabilitation outcomes after SCI.

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Physical activity is related to lower levels of pain, fatigue and depression in individuals with spinal-cord injury: a correlational study

Cited by 124 publications

References 23 publications

Fatigue in persons with subacute spinal cord injury who are dependent on a manual wheelchair

Fatigue in persons with subacute spinal cord injury who are dependent on a manual wheelchair

The relationship between fatigue and participation in spinal cord injury

Virtual feedback for motor and pain rehabilitation after spinal cord injury

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