Pain and fatigue as mediators of the relationship between mobility aid usage and depressive symptomatology in ambulatory individuals with SCI

Spinal Cord, 2014 · DOI: 10.1038/sc.2013.164 · Published: April 1, 2014

Spinal Cord Injury Mental Health Rehabilitation

Simple Explanation

This study explores how pain and fatigue might explain the connection between using mobility aids (like wheelchairs or canes) and experiencing depressive symptoms in people with spinal cord injuries (SCI) who can still walk. The research found that using people for assistance in walking is linked to higher chances of depressive symptoms, while consistently using a wheelchair is linked to lower chances of depressive symptoms. However, these links become less clear when considering the roles of pain and fatigue, suggesting that pain and fatigue may help explain why mobility aid usage and depressive symptoms are related.

Study Duration

Not specified

Participants

652 ambulatory adults with chronic SCI

Evidence Level

Cross-sectional cohort study

Key Findings

1
Using people as a mobility aid was associated with increased odds of depressive symptomatology.
2
Always using a wheelchair was associated with lower odds of depressive symptomatology.
3
Pain and fatigue mediate the relationship between usage of certain mobility aids and depressive symptomatology.

Research Summary

This study investigated the relationship between mobility aid usage, pain, fatigue, and depressive symptoms in ambulatory individuals with SCI. The findings suggest that pain intensity and fatigue are mediators in the relationship between ambulatory status and depressive symptoms. The study highlights the need to monitor pain and fatigue in long-term ambulators with SCI to avoid complications, particularly depressive symptoms.

Practical Implications

Tailored Interventions

Therapists can tailor interventions to obtain the most beneficial results and monitor the extent to which secondary complications may develop in conjunction with ambulation.

Awareness of Increased Risk

Rehabilitation professionals need to be aware of the increased risk of depressive symptoms to modify treatment programs and alert appropriate professionals if need be.

Consideration of Long-Term Effects

Therapists ought to consider the potential long-term effects of advocating for reduced wheelchair usage and the introduction of mobility aids offering less support during ambulation.

Study Limitations

1
All data were self-report.
2
Data were cross-sectional; therefore, evaluation of changes was not possible.
3
Inclusion criteria were limited to traumatic SCI only; thus, the findings may not be generalizable to individuals with injuries of nontraumatic etiology.

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