Measuring fatigue in persons with spinal cord injury.
OBJECTIVE
To evaluate the psychometric properties of the Fatigue Severity Scale (FSS) in persons with spinal cord injury (SCI).


METHODS
A 2-week methodologic study was conducted to assess the internal consistency, reliability, and construct validity of the FSS.


METHODS
A tertiary spinal cord rehabilitation facility.


METHODS
Forty-eight community-living subjects at least 1 year post-SCI with American Spinal Injury Association (ASIA) grade A or B SCI and no medical conditions causing fatigue. The sample was predominantly male (n=31 [65%]) with tetraplegia (n=26 [54%]) and ASIA grade A injuries (n=30 [63%]). The average duration since injury was 14.9 years.


METHODS
Not applicable.


METHODS
The ASIA Impairment Scale, the FSS, a visual analog scale for fatigue (VAS-F), the vitality scale of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), and the Center for Epidemiologic Studies Depression Scale (CES-D).


RESULTS
Mean FSS score +/- standard deviation at baseline was 4.4+/-1.4, with 54% (n=26) scoring greater than 4. The internal consistency of the FSS was excellent (Cronbach alpha=.89). Two-week test-retest reliability was adequate (intraclass correlation coefficient, .84; 95% confidence interval, .74-.90). The magnitude of the relationship was as hypothesized for the VAS-F (r=.67) and CES-D (r=.58) and lower than hypothesized for the vitality subscore (r=-.48) of the SF-36.


CONCLUSIONS
The FSS has acceptable reliability with regard to internal consistency, test-retest reliability, and validity in persons with motor complete SCI.
Anton
Hubert A
HA
Division of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver, BC, Canada. hanton@pacificrehab.net
Miller
William C
WC
Townson
Andrea F
AF
D000328:Adult; D017677:Age Distribution; D015331:Cohort Studies; D016001:Confidence Intervals; D005221:Fatigue / Q000453:epidemiology* / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D011336:Probability; D011594:Psychometrics; D012372:ROC Curve; D012047:Rehabilitation Centers; D015203:Reproducibility of Results; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D013119:Spinal Cord Injuries / Q000150:complications* / Q000175:diagnosis / Q000534:rehabilitation*