title: Fatigue in persons with subacute spinal cord injury who are dependent on a manual wheelchair.
abstract: METHODS
  Cross-sectional.
  
  
  OBJECTIVE
  To determine the prevalence and severity of fatigue in persons with subacute spinal cord injury (SCI), assess whether demographic and lesion characteristics are related to fatigue and determine the relationship with physical fitness and physical behavior.
  
  
  METHODS
  Measurements were performed 2 months before discharge from inpatient rehabilitation.
  
  
  METHODS
  Thirty-six persons with subacute SCI, dependent on a manual wheelchair, mean age 43±15 and 83% men, completed the Fatigue Severity Scale (FSS). FSS scores >4 indicated fatigue. We recorded age and lesion characteristics, measured body mass index, measured peak power output and peak oxygen uptake during a maximal handcycling test and determined physical behavior using an accelerometer-based activity monitor. T-tests were used to test for differences in fatigue between subgroups based on age and lesion characteristics, and regression analyses to assess the relationship with physical fitness and physical behavior.
  
  
  RESULTS
  Mean FSS was 3.3±1.3. Fatigue, including severe fatigue, was prevalent in 31% (95% confidence interval: 16-46) of participants compared with 18% in the general population. Furthermore, mean fatigue was significantly higher in persons with incomplete compared with complete lesions (t=2.22, P=0.03). Mean scores between other subgroups did not differ significantly. Of the physical fitness and physical behavior measures, only peak oxygen uptake tended to be related to more fatigue (B=-1.47, P=0.05).
  
  
  CONCLUSIONS
  Fatigue was prevalent and is of concern in persons with subacute SCI. Those with incomplete lesions seem to be at higher risk. Because fatigue is known to persist among persons with SCI, interventions to reduce fatigue seem necessary.
authors.affiliation: Erasmus MC University Medical Center, Department of Rehabilitation Medicine, Rotterdam, The Netherlands.
authors.forename: C F J
authors.initials: CF
authors.lastname: Nooijen
authors.affiliation: Rijndam Rehabilitation Institute, Rotterdam, The Netherlands.
authors.forename: S
authors.initials: S
authors.lastname: Vogels
authors.affiliation: Adelante Rehabilitation Center, Hoensbroek, The Netherlands.
authors.forename: H M H
authors.initials: HM
authors.lastname: Bongers-Janssen
authors.affiliation: Rijndam Rehabilitation Institute, Rotterdam, The Netherlands.
authors.forename: M P
authors.initials: MP
authors.lastname: Bergen
authors.affiliation: Erasmus MC University Medical Center, Department of Rehabilitation Medicine, Rotterdam, The Netherlands.
authors.forename: H J
authors.initials: HJ
authors.lastname: Stam
authors.affiliation: Erasmus MC University Medical Center, Department of Rehabilitation Medicine, Rotterdam, The Netherlands.
authors.forename: H J G
authors.initials: HJ
authors.lastname: van den Berg-Emons
mesh_terms: D061725:Accelerometry; D000328:Adult; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005080:Exercise Test; D005221:Fatigue / Q000453:epidemiology / Q000503:physiopathology*; D005260:Female; D006225:Hand / Q000503:physiopathology; D006801:Humans; D007297:Inpatients; D008137:Longitudinal Studies; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology; D010101:Oxygen Consumption / Q000502:physiology; D010809:Physical Fitness / Q000502:physiology; D015995:Prevalence; D012047:Rehabilitation Centers; D012720:Severity of Illness Index; D013119:Spinal Cord Injuries / Q000453:epidemiology / Q000503:physiopathology* / Q000534:rehabilitation*; D014910:Wheelchairs