Article

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.

Langue : ANGLAIS