Poststroke Fatigue: An Emerging, Critical Issue in Stroke Medicine

Abstract

Poststroke fatigue is a common and disabling condition. However, few studies on or therapeutic trials addressing poststroke fatigue have appeared in the literature. We aimed to review the prevalence, natural course, potential predisposing factors (physiological, psychocognitive, and organic), and pharmacological and nonpharmacological treatments of poststroke fatigue. Using PubMed CINAHL and PsycINFO, we reviewed all the available literature on poststroke fatigue and related issues. The prevalence of poststroke fatigue ranges from 23% to 75%, depending on the definition of fatigue and the characteristics of the patients included. Poststroke fatigue seems to be of complex etiology. Predisposing factors were physiological ones including functional disability, prestroke fatigue, medical comorbidities, medication, sleep disturbances, and nutritional problems; psychocognitive ones including depression and cognitive dysfunction; and organic ones including damage to particular brain areas with consequent neurochemical alterations, perfusion deficit, and neuroinflammation. Poststroke fatigue is a persistent and debilitating symptom in some patients, and can have adverse affects on patient's neurological recovery, quality of life, and mortality. Few therapeutic trials have been reported, and the therapy was rarely successful, possibly because of the complex nature of poststroke fatigue. Poststroke fatigue is a common and frequently disabling problem of complex etiology. Further studies are urgently needed to improve our understanding of the pathophysiology of poststroke fatigue and to develop better treatments for this condition.

The Nottingham Fatigue after Stroke (NotFAST) study: factors associated with severity of fatigue in stroke patients without depression

“…5,6 However, post-stroke fatigue has also been found independently of low mood. 7,8 No previous studies have excluded participants with depressive symptoms, allowing fatigue to be investigated independently of this factor. Aside from the link with depression, evidence identifying other factors associated with post-stroke fatigue is limited and often conflicting.…”

Characteristics Of Fatigue Post Stroke Patient’s

“…Prevalensi fatigue pada kasus ini di Amerika diperkirakan 36%-77% (Kluger et al, 2013), sedangkan di Korea diperkirakan 23%-75% (Choi-Kwon & Kim, 2011). Menurut NANDA 2015-2017 fatigue merupakan keletihan yang dirasakan secara terus-menerus dan terjadi penurunan kapasistas fisik dan maupun mental.…”

“…Selain itu kasus ini dapat dihubungkan dengan penurunan aktivitas seksual dari penderitanya (Choi-Kwon & Kim, 2011).…”

Group Circuit Class Therapy for Stroke Survivors – A Review of the Evidence and Clinical Implications

“…survivors. Fatigue and depression are often problems for stroke patients (Hackett et al, 2005;Choi-Kwon & Kim 2011). Several studies have shown that physical training produced a positive effect on non-physical outcomes like fatigue and depression (Sjosten & Kivela 2006;Blake et al, 2009;Mead et al, 2009).…”