The course of fatigue after acute spinal cord injury

Anton, Hubert A.; Miller, William C.; Townson, A F; Imam, Bita; Silverberg, Noah D.; Forwell, Susan

doi:10.1038/sc.2016.102

Cited by 28 publications

(20 citation statements)

References 27 publications

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“…From our recent qualitative study it became clear that spasticity and muscle stiffness impact on physical fitness, while the high levels of attention needed to cope with balance and gait problems seem to cause mental fatigue [16]. Generally, fatigue and pain are serious problems in many types of chronic neurological disorders such as spinal cord injury, stroke, Parkinson's disease, multiple sclerosis, and neuromuscular disease, which require specific clinical attention and treatment [30,[38][39][40][41][42]. Our results indicate that people with HSP form no exception to this rule, and probably remain undertreated in these respects.…”

Section: Muscular and Non-motor Symptomsmentioning

confidence: 99%

Experienced complaints, activity limitations and loss of motor capacities in patients with pure hereditary spastic paraplegia: a web-based survey in the Netherlands

Lith

Kerstens

Bemd

et al. 2020

Orphanet J Rare Dis

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Background: Hereditary spastic paraplegia (HSP) is a group of inherited disorders characterized by progressive spastic paresis of the lower limbs. Treatment is often focused on reducing spasticity and its physical consequences. To better address individual patients' needs, we investigated a broad range of experienced complaints, activity limitations, and loss of motor capacities in pure HSP. In addition, we aimed to identify patient characteristics that are associated with increased fall risk and/or reduced walking capacity. Methods: We developed and distributed an HSP-specific online questionnaire in the Netherlands. A total of 109 out of 166 questionnaires returned by participants with pure HSP were analyzed. Results: Participants experienced the greatest burden from muscle stiffness and limited standing and walking activities, while 72% reported leg and/or back pain. Thirty-five and 46% reported to use walking aids (e.g. crutches) indoors and outdoors, respectively; 57% reported a fall incidence of at least twice a year ('fallers'); in 51% a fall had led to an injury at least once; and 73% reported fear of falling. Duration of spasticity and incapacity to rise from the floor were positively associated with being a 'faller', whereas non-neurological comorbidity and wheelchair use were negatively associated. Higher age, experienced gait problems, not being able to stand for 10 min, and incapacity to open a heavy door showed a negative association with being a 'walker without aids' (> 500 m). Conclusions: Our results emphasize the large impact of spastic paraparesis on the lives of people with pure HSP and contribute to a better understanding of possible targets for rehabilitation.

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Section: Muscular and Non-motor Symptomsmentioning

confidence: 99%

Experienced complaints, activity limitations and loss of motor capacities in patients with pure hereditary spastic paraplegia: a web-based survey in the Netherlands

Lith

Kerstens

Bemd

et al. 2020

Orphanet J Rare Dis

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“…Spinal cord injury (SCI) occurs as the result of damage to the nervous system and spinal cord, associated with bruising or severing in traumatic injuries [1], or to degeneration of the spine, infections, vascular accidents, or cancerous tumours in non-traumatic injuries [2]. SCI is associated with a range of secondary health conditions, including; sleep disturbance [3,4], psychological disorder [5], chronic pain [6], fatigue [7,8], and autonomic nervous system dysfunction [9,10].…”

Section: Introductionmentioning

confidence: 99%

A prospective cohort study investigating contributors to mild cognitive impairment in adults with spinal cord injury: study protocol

et al. 2020

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Background Studies report rates of mild cognitive impairment (MCI) in spinal cord injury (SCI) range between 10 and 60%. This broad estimate of MCI in SCI is most likely a result of: (i) inconsistent operationalization of MCI; (ii) heterogeneity among individuals with SCI; (iii) failure to account for MCI subtypes, thereby adding to the heterogeneity of samples; and, (iv) poor control for traumatic brain injury (TBI) that obscures differentiation of MCI attributable to TBI versus other factors. There is a paucity of longitudinal studies following the course of MCI in SCI, and none that account for multiple predictors of MCI, including interactions among predictors. Methods An inception cohort longitudinal study will assess approximately 100 individuals aged 17–80 years with acute SCI, with measures taken at three timepoints (baseline, 3 months post-baseline, and 12 months post-injury). Data relevant to medical care received within the first 24–48 h of presentation to the emergency department will be analysed, as will measures of cognition, injury characteristics, medical history, personal factors, psychological status, psychosocial functioning, and quality of life. Latent class mixture modelling will determine trajectories for the primary outcome of interest, cognitive functioning and its subtypes, and secondary outcomes of interest such as depression. Multiple regression analyses will identify predictors of MCI and its subtypes. Discussion The prospective design will reveal change in cognitive functioning across time and unveil different outcome trajectories; thus addressing the lack of knowledge on trajectories of MCI and MCI subtypes in SCI. Through subtyping MCI, we hope to yield groups of cognitively impaired individuals with SCI that are potentially more homogenous and thereby stable and predictable. This is the first study to capture emergency department and acute care diagnostic evidence of mild TBI, which has been poorly controlled in previous studies. Our study will also be the first to distinguish the contribution of TBI from other factors to the development of MCI in individuals with SCI. Trial registration The study was prospectively registered with the Australian and New Zealand Clinical Trial Registry (ACTRN12619001702101) on 3rd December 2019.

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“…Secondary health problems may occur as an (in)direct consequence of the SCI but they may also be caused, aggravated or sustained by an improper sitting posture for a prolonged time. Commonly reported sitting-related health problems by persons with SCI are: pressure ulcers, spinal deformities [3,4], respiratory complaints, (lower) back pain [3,5], neck pain [6] weight gain, chronic musculoskeletal pain [4,7] and fatigue [8,9].…”

Section: Introductionmentioning

confidence: 99%

Experienced sitting-related problems and association with personal, lesion and wheelchair characteristics in persons with long-standing paraplegia and tetraplegia

Valent

Nachtegaal²,

Faber

et al. 2019

Spinal Cord

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Study Design Cross-sectional study. Objectives To describe experienced sitting-related health and stability problems among persons with paraplegia (PP) or tetraplegia (TP) and to investigate associations with personal, lesion and wheelchair characteristics as well as satisfaction with sitting posture. Setting Dutch community. Methods A self-report questionnaire on seating was developed and completed by wheelchair-users living with Spinal Cord Injury (SCI) for ≥10 years (N = 264). Sitting-related problems and satisfaction with sitting posture were compared between participants with PP and TP using Chi-square and t-tests. Logistic regression analyses were performed to investigate associated characteristics. Results Reported sitting-related problems comprised: sitting to be tiring (regularly to always) (33%), sitting to be painful (28%), pressure ulcers in the last three months (29%), instability while sitting (8%) and instability during reaching (33%). Except for instability during reaching, no differences in occurrence of sitting-problems were found between lesion-group. Persons with TP were more dissatisfied with their sitting posture than persons with PP: 51% vs 36% (p = 0.022) and 51% and 47% respectively thought their sitting posture could be improved (p = 0.670). 'Experienced lack of support in the wheelchair' was associated with most sitting-problems. Pain and instability were associated with dissatisfaction with sitting posture. Conclusion Sitting-related problems and dissatisfaction with sitting posture were frequently reported by persons with longstanding SCI. Sitting problems appeared to associate with lacking support in the wheelchair/seating. A comprehensive feedback from the wheelchair user and a stability check (reach task), as part of the wheelchair/seating-user fitting, may contribute to prevention of sitting-related problems.

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The course of fatigue after acute spinal cord injury

Abstract: The British Columbia Medical Services Foundation funded our study.

Cited by 28 publications

References 27 publications

Experienced complaints, activity limitations and loss of motor capacities in patients with pure hereditary spastic paraplegia: a web-based survey in the Netherlands

Experienced complaints, activity limitations and loss of motor capacities in patients with pure hereditary spastic paraplegia: a web-based survey in the Netherlands

A prospective cohort study investigating contributors to mild cognitive impairment in adults with spinal cord injury: study protocol

Experienced sitting-related problems and association with personal, lesion and wheelchair characteristics in persons with long-standing paraplegia and tetraplegia

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