Neither patients nor physicians provide valid estimates of maximal walking distance. Patients consistently overestimate their maximal walking distance, whereas physicians tend to underestimate. Interestingly, patients' estimates (although over inflated) do correlate well with actual walking distance, while physician estimates are not at all correlated. This study suggests that reliance on self-reported or physician-estimated maximum walking distances (whether for clinical, research or other reasons) is potentially flawed.

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Background/Objective: To describe a case of fatigue associated with cardiomyopathy in a man with spinal cord injury. Study Design: Case report. Subject: An obese 35-year-old man with long-term ASIA A L2 paraplegia, accompanied by a 2-year history of progressive severe fatigue. Methods: Physical examination showed obesity, hypertension, tachycardia, and pitting edema. An echocardiogram showed a 20% ejection fraction, severe dilation, and global hypokinesis in the left ventricle and mild to moderate mitral regurgitation. Results: Symptoms improved after treatment with furosemide, warfarin, ramipril, and continuous positive airway pressure for obstructive sleep apnea. Conclusion: Severe progressive fatigue in a patient with chronic SCI may signal cardiomyopathy. Diagnostic studies may be warranted in patients with progressive fatigue.

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