Measuring fatigue in persons with spinal cord injury

Hubert A Anton, William C Miller, Andrea F Townson, Hubert A Anton, William C Miller, Andrea F Townson

Abstract

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

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

Setting: A tertiary spinal cord rehabilitation facility.

Participants: 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.

Interventions: Not applicable.

Main outcome measures: 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.

Figures

Figure 1
Figure 1
FATIGUE SEVERITY SCALE QUESTIONNAIRE
Figure 2
Figure 2
Bland Altman Plot of FSS Difference and Average Scores

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Source: PubMed

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