Treatments of fatigue after spinal cord injury: a systematic review and meta-analysis

IF 2.2 4区医学 Q3 CLINICAL NEUROLOGY

Spinal cord Pub Date : 2025-03-06 DOI:10.1038/s41393-025-01067-z

Carlos Leonardo Cano-Herrera, Gita Manhas, Matthew Querée, Bob Hoogenes, Emma A. Bateman, Eldon Loh, William C. Miller, W. Ben Mortenson, Andrea Townson, Janice J. Eng, the SCIRE Research Team

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Abstract

Systematic Review and Meta-analysis. Canada. Fatigue is one of the most common consequences of spinal cord injury (SCI). In this systematic review and meta-analysis, we examined interventions for fatigue in SCI and evaluated their effectiveness. MEDLINE, EMBASE, CINAHL, and PsycINFO databases were searched up to January 2024 inclusive. Randomized controlled trials (RCTs) that assessed any intervention for at least one fatigue outcome in people with SCI were included. Study quality was assessed using the Cochrane Risk of Bias Tool. Initial screening identified 282 studies from which six RCTs were included in the review (N = 249). One study found that moderate-intensity arm-crank exercise significantly improved fatigue compared to a control group (p = 0.036) with a large effect size (standard mean difference [SMD] = 1.05; 95% confidence interval [CI], 0.10–2.00). Two studies assessing behavioral interventions found a moderate effect on fatigue (SMD = 0.46; 95% CI, −0.00–0.92; p = 0.05). Two studies did not find an effect of massage therapy on fatigue (SMD = 0.06; 95% CI, −0.38–0.50; p = 0.80). The risk of bias was classified as High for all but two of the RCTs. These findings suggest that exercise and behavioral interventions promoting an active lifestyle may have a positive effect on fatigue. More research with larger sample sizes, including controls for co-morbid conditions like pain and depression, is needed to establish evidence-based treatments for reducing fatigue in people with SCI.

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脊髓损伤后疲劳的治疗：系统回顾和荟萃分析。

研究设计：系统评价和荟萃分析。设置:加拿大。目的：疲劳是脊髓损伤（SCI）最常见的后果之一。在这篇系统综述和荟萃分析中，我们研究了对脊髓损伤患者疲劳的干预措施并评估了其有效性。方法：检索截至2024年1月（含）的MEDLINE、EMBASE、CINAHL和PsycINFO数据库。随机对照试验（rct）评估了任何干预措施对脊髓损伤患者至少一种疲劳结果的影响。使用Cochrane偏倚风险工具评估研究质量。结果：初步筛选确定了282项研究，其中6项rct纳入了本综述（N = 249）。一项研究发现，与对照组相比，中等强度的摇臂运动显著改善了疲劳（p = 0.036），效果显著(标准平均差[SMD] = 1.05；95%置信区间[CI]， 0.10-2.00)。两项评估行为干预的研究发现，对疲劳的影响适中(SMD = 0.46；95% ci, -0.00-0.92；p = 0.05)。两项研究没有发现按摩治疗对疲劳的影响(SMD = 0.06；95% ci, -0.38-0.50；p = 0.80)。除两项随机对照试验外，其余试验偏倚风险均为高。结论：这些发现表明，促进积极生活方式的运动和行为干预可能对疲劳有积极作用。需要更多样本量更大的研究，包括对疼痛和抑郁等共病条件的对照，以建立以证据为基础的治疗方法来减轻脊髓损伤患者的疲劳。

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来源期刊

Spinal cord 医学-临床神经学

CiteScore

4.50

自引率

9.10%

发文量

142

审稿时长

2 months

期刊介绍： Spinal Cord is a specialised, international journal that has been publishing spinal cord related manuscripts since 1963. It appears monthly, online and in print, and accepts contributions on spinal cord anatomy, physiology, management of injury and disease, and the quality of life and life circumstances of people with a spinal cord injury. Spinal Cord is multi-disciplinary and publishes contributions across the entire spectrum of research ranging from basic science to applied clinical research. It focuses on high quality original research, systematic reviews and narrative reviews. Spinal Cord''s sister journal Spinal Cord Series and Cases: Clinical Management in Spinal Cord Disorders publishes high quality case reports, small case series, pilot and retrospective studies perspectives, Pulse survey articles, Point-couterpoint articles, correspondences and book reviews. It specialises in material that addresses all aspects of life for persons with spinal cord injuries or disorders. For more information, please see the aims and scope of Spinal Cord Series and Cases.