Symptom Burden in Persons With Spinal Cord Injury

Jensen, Mark P.; Kuehn, Carrie M.; Amtmann, Dagmar; Cardenas, D D

doi:10.1016/j.apmr.2007.02.002

Cited by 143 publications

(136 citation statements)

References 62 publications

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“…This is a more complex phenomenon than the commonly posited, linear equation in which fatigue is viewed as a purely physical phenomenon leading to diminished physical independence and resulting from reduced energy, disuse or overuse. 4 The results of this study identified close interrelationships between fatigue, depression, pain and hopelessness, which some participants viewed as inseparable. However, during the dynamic interchanges that often occur within focus groups, other participants challenged this viewpoint and raised the possibility that once fatigue was 'named', specific strategies could be enacted to enable some control over this dimension of their lives.…”

Section: Discussionmentioning

confidence: 72%

“…17 The physical sequelae of SCI dictate that an enormous degree of effort is expended to accomplish daily activities, even in the absence of depression, pain and fatigue and in the presence of motivation. High levels of fatigue, 4,7 depression 18 and pain 4,19,20 among people with SCI, and the observed interconnections between these factors, suggest that sustained engagement in activities that are personally meaningful and rewarding may be inordinately difficult following SCI.…”

Section: Discussionmentioning

confidence: 99%

“…From their clinical experience the review's authors noted that cognitive complaints (attention, concentration and memory) accompany 'chronic fatigue' in SCI, yet contended that prevention depends on fighting physical deconditioning. This overlooks the identified linkages between overuse and fatigue 1,4,8 and sidesteps the reality that fatigue is not activityspecific (and thus related to specific muscle weakness). 10 Chart review at the GF Strong Rehabilitation Centre in Vancouver, British Columbia (BC) found that 57% of outpatients with SCI of greater than 1-year duration reported fatigue of sufficient severity to interfere with function.…”

Section: Introductionmentioning

confidence: 99%

“…Although fatigue affects many people with spinal cord injury (SCI), [1][2][3][4] it is a poorly understood phenomenon. Some researchers report significantly worse fatigue among those with complete tetraplegia 1,2,5 whereas others equate the greatest fatigue with incomplete lesions and paraplegia.…”

Section: Introductionmentioning

confidence: 99%

“…Fatigue magnifies the physical consequences of SCI by further compromising the ability to participate in life activities, 2 yet little is known about the nature, course or treatment of fatigue among people with SCI, suggesting that research is 'urgently needed'. 4 The current study, undertaken collaboratively by researchers from the University of British Columbia and the British Columbia Paraplegic Association (BCPA) Peer Program, was designed to explore the experience of, and contributors to fatigue following SCI and identify successful management strategies and appropriate interventions. This paper addresses the first aspect of the study: an analysis of the experience of, and contributors to fatigue among people with SCI.…”

Section: Introductionmentioning

confidence: 99%

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Fatigue and spinal cord injury: a qualitative analysis

et al. 2008

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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.

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Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Fatigue and spinal cord injury: a qualitative analysis

et al. 2008

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Pain prevalence and its determinants after spinal cord injury: A systematic review

Gorp

Kessels

Joosten

et al. 2014

European Journal of Pain

118

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Pain prevalence studies are important as they illustrate the magnitude of pain problems in a certain patient population, such as patients living with a spinal cord injury (SCI). Strikingly, reported pain prevalence rates in SCI patients are found to vary greatly, while determinants for the differences between pain prevalence reports remain unclear. We here aim to identify determinants for the differences (heterogeneity) in pain prevalence reports through a systematic review of all SCI pain prevalence reporting studies. Literature search was done using Medline, Cumulative Index to Nursing and Allied Health Literature, ISI Web of Knowledge and Embase. Data abstraction was performed while blinded and was followed by meta-(regression)-analyses. We identified 82 studies. Study design-related determinants of SCI pain prevalence reports were pain definition strictness (mild, moderate or high), primary study goal (pain study or not), data source (retrospective or not), and in a limited number of cases response/attrition rates. While correcting for these items, population characteristics correlating with pain prevalence rates were both proportion of patients with a depression and average time after injury (positive correlations). Between-study heterogeneity may remain even after the identification/correction of above-mentioned causes of heterogeneity.Pain after SCI does seem to relate to the duration of the injury and depression, yet major causes of bias in reported pain prevalence are found to be related to the primary study goal (pain study or not), choice of pain definition and the use of retrospective data.

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Unilateral T13 and L1 Dorsal Root Avulsion: Methods for a Novel Model of Central Neuropathic Pain

Wieseler¹,

Ellis²,

Maier³

et al. 2012

Methods in Molecular Biology

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Central neuropathic pain is associated with many disease states including multiple sclerosis, stroke, and spinal cord injury, and is poorly managed. One type of central neuropathic pain that is particularly debilitating and challenging to treat is pain that occurs below the level of injury (below-level pain). The study of central neuropathic pain is commonly performed using animal models of stroke and spinal cord injury. Most of the spinal cord injury models currently being used were originally developed to model the gross physiological impact of clinical spinal cord injury. In contrast, the T13/L1 dorsal root avulsion model of spinal cord injury described here was developed specifically for the study of central pain, and as such, was developed to minimize confounding complications, such as paralysis, urinary tract infections, and autotomy. As such, this model induces robust and reliable hindpaw mechanical allodynia. Two versions of the model are described. The first is optimal for testing systemically administered pharmacological manipulations. The second was developed to accommodate intrathecal application of pharmacological manipulations. This model provides an additional means by which to investigate central pain states associated with spinal cord injury, including below-level pain. Finally, a brief discussion of at-level pain measurement is described as it has been suggested in the literature that the mechanisms underlying below- and at-level pain are different.

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Symptom Burden in Persons With Spinal Cord Injury

Cited by 143 publications

References 62 publications

Fatigue and spinal cord injury: a qualitative analysis

Fatigue and spinal cord injury: a qualitative analysis

Pain prevalence and its determinants after spinal cord injury: A systematic review

Unilateral T13 and L1 Dorsal Root Avulsion: Methods for a Novel Model of Central Neuropathic Pain

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