TY  - JOUR
PY  - 2014//
TI  - Pain and fatigue as mediators of the relationship between mobility aid usage and depressive symptomatology in ambulatory individuals with SCI
JO  - Spinal Cord
A1  - Dipiro, N. D.
A1  - Saunders, L. L.
A1  - Brotherton, S.
A1  - Kraft, S.
A1  - Krause, J. S.
SP  - 316
EP  - 321
VL  - 52
IS  - 4
N2  - Study design:Cross-sectional cohort study.    OBJECTIVES:To investigate a mediational model where pain (intensity and interference) and fatigue mediate the relationship between the use of mobility aids and moderate-to-severe depressive symptomatology among ambulatory participants with spinal cord injury (SCI).    Setting:A medical university in the southeastern United States.    METHODS:Ambulatory adults (N=652) with chronic SCI responded to a mail-in survey. The Patient Health Questionnaire-9 was used to assess moderate-to-severe depressive symptomatology. The Brief Pain Inventory was used to assess pain intensity and interference, and the Modified Fatigue Impact Scale-5-item version was used to assess fatigue. Participants self-reported use of mobility aids.    RESULTS:On examining mobility aids used for ambulation, 65% were found to have used at least one aid. Severe pain intensity was reported by 11%, and 14% reported severe pain interference. Disabling fatigue was reported by 10% of the participants. Twenty-one percent (n=138) reported moderate-to-severe levels of depressive symptoms. On examining the relationships between mobility aids and depressive symptomatology, using people as a mobility aid was associated with increased odds of depressive symptomatology (2.6) and always using a wheelchair was associated with lower odds (0.3). However, these relationships were no longer significant after controlling for the mediating variables pain intensity, pain interference and fatigue.    CONCLUSIONS:Pain and fatigue mediate the relationship between usage of certain mobility aids and depressive symptomatology. The use of people to assist in ambulation is associated with greater odds of moderate-to-severe depressive symptomatology, while always using a wheelchair is associated with lower odds.Spinal Cord advance online publication, 14 January 2014; doi:10.1038/sc.2013.164.<p />  <p>Language: en</p>
LA  - en
SN  - 1362-4393
UR  - http://dx.doi.org/10.1038/sc.2013.164
ID  - ref1
ER  -