Impact of fatigue on the health-related quality of life in persons with spinal cord injury.

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Journal Article
Archives of physical medicine and rehabilitation, 2012, 93 (2), pp. 319 - 324
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OBJECTIVE: To study the impact of fatigue on health-related quality of life (HR-QOL) associated with spinal cord injury (SCI). DESIGN: Matched group design with several independent measures. SETTING: University-based laboratory. PARTICIPANTS: Persons with SCI (n=41) and an average 16.5 years duration of community living with SCI and a group of able-bodied controls (n=41) with similar sex ratio, age, and level of education. Participants with SCI were enrolled through rehabilitation unit contacts and through advertising in newsletters. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The main independent measures reported in this article include the Iowa Fatigue Scale and the Medical Outcomes Study 36-Item Short-Form Health Survey. RESULTS: As expected, persons with SCI were found to have significantly lower HR-QOL. Fatigue was found to be more prevalent in the SCI group, and was associated with lower HR-QOL in both groups. Factorial analysis of variance indicated significant interactions in which persons with SCI with low fatigue levels had similar HR-QOL to the able-bodied controls regardless of their fatigue level, while persons with SCI with elevated fatigue had significantly reduced HR-QOL. Factors such as age, education, completeness and level of lesion, and community integration were not associated with increased fatigue levels. However, a shorter time since injury was found to be significantly associated with higher levels of fatigue. CONCLUSIONS: The Iowa Fatigue Scale data suggest over 50% of the SCI group had elevated fatigue, which was associated with significantly reduced HR-QOL. Research is needed that identifies factors that raise vulnerability to fatigue, and strategies designed to address the negative impacts of fatigue need to be evaluated.
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