Unique Contribution of Fatigue to Disability in Community-Dwelling Adults With Traumatic Brain Injury

Objective: To examine the unique contribution of fatigue to self-reported disability in community-dwelling adults with traumatic brain injury (TBI). Design: A cross-sectional cohort design. Setting: Community dwellings. Participants: Adults (N=50) with a history of mild to severe TBI were assessed. Intervention: Not applicable. Main Outcome Measures: This study assessed the contribution of fatigue (Modified Fatigue Impact Scale) to disability (Mayo-Portland Adaptability Inventory), controlling for executive functions (Frontal Systems Behavior Scale), depression status (major depression in partial remission/current major depression/depressive symptoms or no history of depression), and initial injury severity (uncomplicated mild, complicated mild, moderate, or severe). Results: Fatigue was found to contribute uniquely to the variance in self-reported disability (beta=.47, P<.001) after controlling for injury severity, executive functions, and depression status. The overall model was significant (F-4,F-45=17.32, P<001) and explained 61% of the variance in self-reported disability, with fatigue alone accounting for 12% of the variance in self-reported disability (F-1,F-45=13.97, P<.001). Conclusions: Fatigue contributes uniquely to disability status among community-dwelling adults with chronic TBI, independent of injury severity, executive functions, and depression. Addressing fatigue through targeted interventions may help to improve self-perceived disability in this population. Archives of Physical Medicine and Rehabilitation 2013;94:74-9 (C) 2013 by the American Congress of Rehabilitation Medicine