title: Effects of pain and fatigue on physical functioning and depression in persons with muscular dystrophy.
abstract: BACKGROUND
  Pain and fatigue are common symptoms experienced by persons with muscular dystrophy (MD). However, it is unclear from previous studies whether pain and fatigue have independent effects on physical functioning and depression, and whether age moderates the relationship of pain and fatigue with physical functioning and depression.
  
  
  OBJECTIVE
  This cross-sectional study aimed to describe the relationship of pain and fatigue to physical functioning and depression in persons 20-89 years old with MD.
  
  
  METHODS
  A convenience sample of 332 individuals with MD completed a questionnaire that included measures of physical functioning (PROMIS item bank items), depression (PHQ-9), pain intensity (0-10 NRS), and fatigue (0-10 NRS).
  
  
  RESULTS
  Pain and fatigue were each independently associated with physical functioning and depression. Depressive symptoms were most severe among middle-aged participants (45-64 years old) relative to older and younger participants. Physical functioning had a negative relationship with chronological age.
  
  
  CONCLUSIONS
  Symptoms of pain and fatigue are significantly and independently related to physical functioning and depression in persons with MD. Research is needed to determine if treatments that target both pain and fatigue in patients with MD have more beneficial effects than treatments that target only one of these symptoms.
authors.affiliation: Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA 98104, USA. kalschul@uw.edu
authors.forename: Kevin N
authors.initials: KN
authors.lastname: Alschuler
authors.forename: Mark P
authors.initials: MP
authors.lastname: Jensen
authors.forename: Mark C
authors.initials: MC
authors.lastname: Goetz
authors.forename: Amanda E
authors.initials: AE
authors.lastname: Smith
authors.forename: Aimee M
authors.initials: AM
authors.lastname: Verrall
authors.forename: Ivan R
authors.initials: IR
authors.lastname: Molton
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology*; D006233:Persons with Disabilities / Q000523:psychology; D005221:Fatigue / Q000150:complications* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009136:Muscular Dystrophies / Q000150:complications* / Q000523:psychology; D010146:Pain / Q000150:complications* / Q000523:psychology; D055815:Young Adult