Depressive Mood and Fatigue in Iranian Patients With Spinal Cord Injury and Spared Walking Ability

Fatigue and depression are common after spinal cord injury (SCI). However, their extent in individuals with spared ability to walk (assisted or nonassisted) has not yet been described in Iranian patients. Our purpose was to evaluate fatigue, depressive mood, and neuropathic pain among Iranian patients with spared ability. Patients with traumatic SCI who had spared walking ability with spinal cord independence scores (SCIM) higher than 65, referred to Brain and Spinal Injury Research Center (BASIR) between September 2012 and October 2013 were entered to the study. Fatigue, depressive mood and pain were evaluated using modified fatigue impairment scale (MFIS) for SCI (MFIS-SCI), Beck depression inventory (BDI), and 0-10 numerical rating scale (NRS), respectively. Among 30 patients who entered this investigation, 66.7% had normal moods (BDI < 10) and only 3.3% showed severe depression (BDI: 31-40). The mean total score of MFIS-SCI was 22.46 ± 15.76. Higher scores of BDI were significantly associated with higher scores of MFIS-SCI in all cognitive (P < 0.0001, r = 0.81), physical (P = 0.001, r = 0.58) and psychosocial (P = 0.001, r = 0.57) domains. Based on the previously measured cutoff point in MFIS-SCI, 53.3% of our patients were fatigued. Patients with cervical level injury had significantly higher fatigue impacts (P: 0.036). This study showed that a majority of patients with traumatic SCI who had spared ability of walking were fatigued, while depressive mood was less frequent among these patients. Neuropathic pain was not a determinant for fatigue and depression. Although the extent of physical activity was relatively similar among these patients, those with higher injury levels had higher fatigue impacts.