Development and Psychometric Evaluation of a Fatigability Index for Full-Time Wheelchair Users With Spinal Cord Injury.
Alina Ionela Palimaru, William E Cunningham, Marcus Dillistone and 3 others
PMID 29704507WHAT IT FOUND
Full-time wheelchair users with spinal cord injury reported physical and mental fatigue across many activities.
The new physical and mental scales each behaved mainly as one overall score, but they were tested in a self-selected sample and are not proof of treatment benefit.
Key findings
01The final sample was 464 adults with self-reported spinal cord injury who were full-time wheelchair users.
02The physical and mental fatigability scales behaved primarily as single overall scores rather than cleanly separate domains.
03The physical and mental fatigability scores were highly related (0.92), and adjusting for diagnosis-related item differences changed group mean differences by only 0.07 standard deviation units for physical and 0.10 for mental scores.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The sample was a non-probability convenience sample recruited through advertisements and peer groups, so it may not represent all full-time wheelchair users with spinal cord injury. The response rate is unknown because the denominator was not known, and participants were self-selected. All respondents chose online completion, so the scale has not been formally checked across community and clinical settings or modes of administration. The hypothesized multi-domain factor structures did not fit well, and some items were too closely related to other items or had answer choices that did not separate fatigue levels well. The paper reports measurement properties, not treatment effects.
Declared interests
The authors declared no direct conflict of interest. The article is listed as receiving NIH and non-U.S. government research support.
The easy way to misread this
Do not read this as evidence that the Fatigability Index improves rehabilitation outcomes. It evaluated self-report scales in a convenience sample, not tested interventions.