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Spinal Cord. 2016 Jun;54(6):457-62. doi: 10.1038/sc.2015.149. Epub 2015 Sep 15.

The relationship between fatigue and participation in spinal cord injury.

Smith EM1,2,3,4, Imam B1,2,3,4, Miller WC2,3,4,5,6, Silverberg ND3,4,6,7, Anton HA3,4,6,7, Forwell SJ4,5, Townson AF3,4,6,7.

Author information

1
Faculty of Medicine, Graduate Program in Rehabilitation Sciences, University of British Columbia, Vancouver, British Columbia, Canada.
2
GF Strong Rehabilitation Research Lab, Vancouver, British Columbia, Canada.
3
Rehabilitation Research Program, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada.
4
International Collaboration on Repair Discoveries, Vancouver, British Columbia, Canada.
5
Faculty of Medicine, Department of Occupational Sciences and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada.
6
GF Strong Rehabilitation Centre, Vancouver Coastal Health Authority, Vancouver, British Columbia, Canada.
7
Division of Physical Medicine and Rehabilitation, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.

Abstract

STUDY DESIGN:

Cross-sectional national survey.

OBJECTIVES:

To explore the association between fatigue and community participation frequency and provide an adjusted model of the relationship including important covariates.

SETTING:

Canada; Community.

METHODS:

Data were obtained from the Rick Hansen Spinal Cord Injury Registry Community Survey. We used multi-variable regression analyses with hierarchical backward elimination, including variable specification, interaction assessment and confounding assessment. Variables with statistically significant correlation with the primary-dependent variable (participation) were included for modeling.

RESULTS:

The crude model of association between fatigue and participation accounted for 7.2% of the variance in participation scores. The full model with all a priori selected variables accounted for 25.1% of variance in participation scores. The adjusted model, including the identified confounders (pain, depressive mood, comorbidities and level of injury), accounted for 21.1% of variance in participation scores. Depressive mood variables had the highest standardized beta coefficients, reflecting the largest contribution to this model.

CONCLUSION:

Fatigue has a statistically significant negative association with participation for individuals with spinal cord injury, when controlling for pain, depressive mood, comorbidities and level of injury. Multifaceted clinical interventions and research addressing fatigue, pain and depressive symptoms are warranted.

PMID:
26369887
DOI:
10.1038/sc.2015.149
[Indexed for MEDLINE]

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