Original article
Poststroke Fatigue: Course and Its Relation to Personal and Stroke-Related Factors

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Abstract

Schepers VP, Visser-Meily AM, Ketelaar M, Lindeman E. Poststroke fatigue: course and its relation to personal and stroke-related factors.

Objectives

To describe the course of fatigue during the first year poststroke and to determine the relation between fatigue at 1 year poststroke and personal characteristics, stroke characteristics, and poststroke impairments.

Design

Inception cohort.

Participants

Patients (N=167) with a first-ever supratentorial stroke admitted for inpatient rehabilitation.

Interventions

Not applicable.

Main Outcome Measure

The Fatigue Severity Scale measured the presence and impact of fatigue at admittance for inpatient rehabilitation, as well as at 6 months and 1 year poststroke.

Results

At admission, 6 months and 1 year poststroke, fatigue was present in 51.5%, 64.1%, and 69.5% of the patients, respectively. Fatigue impact 1 year poststroke was greater among patients with more depressive symptoms, higher age, women, and patients with a locus of control more directed to powerful others.

Conclusions

Because fatigue impact is an increasing problem during the first year poststroke, it deserves more attention in clinical practice and scientific research. Locus of control and depression are related to poststroke fatigue and might be important foci for future interventions.

Section snippets

Participants

Subjects were selected from stroke patients consecutively admitted to 4 Dutch rehabilitation centers (see Acknowledgments) according to the following inclusion criteria: (1) admittance for inpatient rehabilitation, (2) first-ever stroke, (3) unilateral supratentorial lesion, and (4) age above 18. Exclusion criteria were (1) disabling comorbidity (prestroke Barthel Index score <18), (2) inability to speak Dutch, and (3) aphasia. The medical ethics committees of University Medical Center Utrecht

Results

A total of 228 patients were included in the study. Eight patients died before the 1-year follow-up, 15 had a recurrent stroke, 21 refused further participation, and 17 patients had missing scores on 1 or more measures. Thus, data from 167 patients were available for analysis.

Patients were relatively young, and the majority lived with a partner (table 1). Infarctions were more frequent than hemorrhages. At 1 year poststroke, 11.4% of the patients were considered cognitively impaired as

Discussion

The percentage of patients reporting fatigue increased over time: its prevalence increased from half of the patients at admission to two thirds of the patients at 1 year poststroke. Fatigue impact scores increased significantly during the first year poststroke. Fatigue impact at 1 year poststroke was greater among patients with more depressive symptoms, higher age, female sex, and patients with a locus of control more directed to powerful others.

The prevalence of poststroke fatigue was

Conclusions

Fatigue is an important poststroke impairment and its impact on everyday life increased during the first year poststroke. Depression, age, sex, and health-related locus of control were related to poststroke fatigue. Patient education on poststroke fatigue should be routinely given to patients and their families. Depression and locus of control could become important foci for interventions. Future research should focus on a more detailed exploration of the determinants of poststroke fatigue and

Acknowledgments

The FuPro study group is Guus J. Lankhorst, Joost Dekker, Annet J. Dallmeijer, Maarten J. IJzerman, Heleen Beckerman, and Vincent de Groot from VU University Medical Center Amsterdam (project coordination); Arie J. Prevo, Eline Lindeman, Vera P. Schepers, and Ingrid G. van de Port from University Medical Center, Utrecht; Henk J. Stam, Else Odding, and Bianca van Baalen from Erasmus Medical Center, Rotterdam; and Anita Beelen and Imelda J. de Groot from Amsterdam Medical Center, Amsterdam. We

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  • Cited by (0)

    Supported by The Netherlands Organization for Health Research and Development (grant no. 1435.0001), as part of the Functional prognostication and disability study on neurological disorders (FuPro), supervised by the Department of Rehabilitation Medicine of the VU Medical Center, Amsterdam.

    No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.

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