title: Impact of fatigue on the health-related quality of life in persons with spinal cord injury.
abstract: OBJECTIVE
  To study the impact of fatigue on health-related quality of life (HR-QOL) associated with spinal cord injury (SCI).
  
  
  METHODS
  Matched group design with several independent measures.
  
  
  METHODS
  University-based laboratory.
  
  
  METHODS
  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.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  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.
authors.affiliation: Rehabilitation Studies Unit, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.
authors.forename: Nirupama
authors.initials: N
authors.lastname: Wijesuriya
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Tran
authors.forename: James
authors.initials: J
authors.lastname: Middleton
authors.forename: Ashley
authors.initials: A
authors.lastname: Craig
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D016022:Case-Control Studies; D005221:Fatigue / Q000150:complications* / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D013119:Spinal Cord Injuries / Q000150:complications*; D013997:Time Factors