How Do Fluctuations in Pain, Fatigue, Anxiety, Depressed Mood, and Perceived Cognitive Function Relate to Same-Day Social Participation in Individuals With Spinal Cord Injury?

Arch Phys Med Rehabil, 2022 · DOI: 10.1016/j.apmr.2021.07.809 · Published: March 1, 2022

Spinal Cord Injury Rehabilitation Public Health

Simple Explanation

This study looks at how daily changes in common symptoms experienced by people with spinal cord injury (SCI), such as pain, fatigue, mood and cognitive function, affect their ability to participate in social activities on the same day. The researchers found that on days when people with SCI experienced increased fatigue and depressed mood, and decreased cognitive function, they participated less in social activities. These findings suggest that managing these specific symptoms on a daily basis may help improve social participation for individuals with SCI.

Study Duration

7-day home monitoring period

Participants

168 individuals with SCI (mean age, 49.8y; 63% male, 37% female)

Evidence Level

Observational study

Key Findings

1
Daily increases in fatigue and depressive symptoms were significantly related to worse same-day social participation in individuals with SCI.
2
Decreases in perceived cognitive function were significantly related to worse same-day social participation in individuals with SCI.
3
Daily fluctuations in anxiety and pain were unrelated to same-day social participation.

Research Summary

This study examined the same-day associations of pain, fatigue, anxiety, depressed mood, and perceived cognitive function with social participation in adults with spinal cord injury (SCI). The results indicated that daily increases in fatigue and depressive symptoms and decreases in perceived cognitive function were significantly related to worse same-day social participation. The study concludes that addressing these within-person fluctuations in symptoms may help optimize social participation in individuals with SCI.

Practical Implications

Targeted Treatment Planning

Clinicians can use the findings to develop targeted interventions that address fatigue, depressed mood, and cognitive function to maximize social participation in people with SCI.

Person-Centered Approach

Encourages a patient-centered approach to assessment and treatment of symptom burden, focusing on daily fluctuations rather than just clinical cut-off points.

Enhance Rehabilitation Programs

Rehabilitation programs should consider the importance of addressing somatic and psychological symptoms alongside physical impairments and environmental barriers.

Study Limitations

1
The sample was predominantly male and White, potentially limiting generalizability to women and racial minorities with SCI.
2
The cross-sectional nature of the data limits causal interpretations regarding the effect of symptoms on patient functioning.
3
Future work could further expand this examination to look at how daily fluctuations in additional symptoms (such as problems in bladder and bowel function) affect social participation

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