Prevalence of Fatigue and Associated Factors in a Spinal Cord Injury Population: Data from an Internet-Based and Face-to-Face Surveys

Abstract

Fatigue has a profound impact on patients with spinal cord injury (SCI), but only limited treatments are available. The aim of this study was to determine the prevalence of fatigue in SCI and its association with clinical and demographic factors. We used an internet-based survey and a face-to-face interview to estimate the prevalence of fatigue in a SCI population. Fatigue was measured using the Fatigue Severity Scale (FSS). Clinically significant fatigue was defined as FSS scores greater than or equal to four. A total of 253 participants with SCI were included in the study. Clinically significant fatigue was present in one third of our sample. There was no relationship between fatigue and injury level or completeness. We found significant correlations between depression, pain, and level of injury. The relation of fatigue with completeness of injury and spasticity is less clear. Moreover, the online survey and the standard face-to-face interview showed similar results concerning fatigue evaluation. Several factors may contribute to fatigue, however. Future studies should be conducted to clarify which are the most relevant ones and, if possible, to determine which factors are modifiable.

Cross-Cultural Adaptation and Validation of the Kannada version Fatigue Severity Scale among Kannada-speaking Individuals with Neurological Disorders: a Cross-Sectional Study done in South India

“…hence those diagnosed with neuropathy and spinal cord diseases showed more fatigue scores than other neurological conditions. These results are supported by earlier studies which revealed high prevalence of fatigue among clients with neuropathy (80%) (Merkies, Schmitz, Samijn, van der Meché & van Doorn, 1999;Merkies & Kieseier, 2016) and spinal cord diseases (37.2%) (Cudeiro-Blanco et al, 2017). Despite the absence of any proven reasons, demyelination and weakness in neuropathy could be the major factors for inducing fatigue in these populations (Garssen, Schillings, Van Doorn, Van Engelen & Zwarts, 2007); White, van Doorn, Garssen & Stockley, 2014).…”

“…Despite the absence of any proven reasons, demyelination and weakness in neuropathy could be the major factors for inducing fatigue in these populations (Garssen, Schillings, Van Doorn, Van Engelen & Zwarts, 2007); White, van Doorn, Garssen & Stockley, 2014). Similarly, sensory loss, pain and depression associated with spinal cord diseases could influence fatigue (Cudeiro-Blanco et al, 2017). These results are contrary to the belief of the current authors who anticipated greater amount of fatigue in stroke survivors than in those with other conditions.…”

Impact of spasticity on functioning in spinal cord injury: an application of graphical modelling

“…This confirms that the prevalence of spasticity in different SCI subgroups should be kept in mind when recognizing the features of spasticity of people's functioning (33). While previous research has stated that the relationship between Spasticity and Tiredness is unclear, this study provides empirical evidence that Tiredness is associated with high levels of Spasticity present mostly in the tetraplegic population (34). Moreover, the mixed results of 2 prospective studies on a relationship between the presence of Urinary tract infection and increased Spasticity may be explained by our results.…”

Difference in fatigue and pain between neuromyelitis optica spectrum disorder and multiple sclerosis

“…Therefore, fatigue in NMOSD patients may be associated with pain caused by extended spinal cord lesions. Indeed, other studies reported fatigue were also common in patients with spinal cord injury [26,27]. However, these reports showed many factors including medication, depression, and pain could affect the fatigue in patients with spinal cord injury.…”