Skip to main content Accessibility help
×
Home

Fatigue Impact Scale Demonstrates Greater Fatigue in Younger Stroke Survivors

  • Natalie E. Parks (a1), Gail A. Eskes (a1), Gordon J. Gubitz (a1), Yvette Reidy (a1), Christine Christian (a1) and Stephen J. Phillips (a1)...

Abstract

Background:

Fatigue affects 33-77% of stroke survivors. There is no consensus concerning risk factors for fatigue post-stroke, perhaps reflecting the multifaceted nature of fatigue. We characterized post-stroke fatigue using the Fatigue Impact Scale (FIS), a validated questionnaire capturing physical, cognitive, and psychosocial aspects of fatigue.

Methods:

The Stroke Outcomes Study (SOS) prospectively enrolled ischemic stroke patients from 2001-2002. Measures collected included basic demographics, pre-morbid function (Oxford Handicap Scale, OHS), stroke severity (Stroke Severity Scale, SSS), stroke subtype (Oxfordshire Community Stroke Project Classification, OCSP), and discharge function (OHS; Barthel Index, BI). An interview was performed at 12 months evaluating function (BI; Modified Rankin Score, mRS), quality of life (Reintegration into Normal living Scale, RNL), depression (Geriatric Depression Scale, GDS), and fatigue (FIS).

Results:

We enrolled 522 ischemic stroke patients and 228 (57.6%) survivors completed one-year follow-up. In total, 36.8% endorsed fatigue (59.5% rated one of worst post-stroke symptoms). Linear regression demonstrated younger age was associated with increased fatigue frequency (β=-0.20;p=0.01), duration (β=-0.22;p<0.01), and disability (β=-0.24;p<0.01). Younger patients were more likely to describe fatigue as one of the worst symptoms post-stroke (β=-0.24;p=0.001). Younger patients experienced greater impact on cognitive (β=-0.27;p<0.05) and psychosocial (β=-0.27;p<0.05) function due to fatigue. Fatigue was correlated with depressive symptoms and diminished quality of life. Fatigue occurred without depression as 49.0% of respondents with fatigue as one of their worst symptoms did not have an elevated GDS.

Conclusions:

Age was the only consistent predictor of fatigue severity at one year. Younger participants experienced increased cognitive and psychosocial fatigue.

    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Fatigue Impact Scale Demonstrates Greater Fatigue in Younger Stroke Survivors
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Fatigue Impact Scale Demonstrates Greater Fatigue in Younger Stroke Survivors
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Fatigue Impact Scale Demonstrates Greater Fatigue in Younger Stroke Survivors
      Available formats
      ×

Copyright

Corresponding author

Qeii Halifax infirmary, Rm 3831, 1796 Summer Street, Halifax, Nova Scotia, B3H 3A7, Canada. Email: Stephen.phillips@cdha.nshealth.ca

References

Hide All
1Deluca, J.Fatigue as a window to the brain. Cambridge, MA: Mit Press, 2005.
2Staub, F, Bogousslavsky, J.Fatigue after stroke: a major but neglected issue. Cerebrovasc Dis. 2001;12(2):7581.
3Vercoulen, JH, Swanink, CM, Fennis, JF, galama, JM, van der Meer, JW, Bleijenberg, G.Dimensional assessment of chronic fatigue syndrome. J Psychosom Res. 1994;38(5):38392.
4Fisk, JD, Ritvo, PG, Ross, L, Haase, DA, Marrie, TJ, Schlech, WF.Measuring the functional impact of fatigue: initial validation of the fatigue impact scale. Clin infect Dis. 1994;18 Suppl 1:S7983.
5Carlsson, GE, Forsberg-Warleby, G, Moller, A, Blomstrand, C.Comparison of life satisfaction within couples one year after a partner’s stroke. J Rehabil Med. 2007;39(3):21924.
6Ingles, JL, Eskes, GA, Phillips, SJ.Fatigue after stroke. Arch Phys Med Rehabil. 1999;80(2):1738.
7Snaphaan, L, van der Werf, S, de Leeuw, FE.Time course and risk factors of post-stroke fatigue: a prospective cohort study. Eur J Neurol. 2011;18(4):6117.
8van der Werf, SP, van den Broek, HL, Anten, HW, Bleijenberg, G.Experience of severe fatigue long after stroke and its relation to depressive symptoms and disease characteristics. Eur Neurol. 2001;45(1):2833.
9Chaudhuri, A, Behan, PO.Fatigue in neurological disorders. Lancet. 2004;363(9413):97888.
10Naess, H, Waje-Andreassen, U, Thomassen, L, Nyland, H, Myhr, KM.Health-related quality of life among young adults with ischemic stroke on long-term follow-up. Stroke. 2006;37(5):12326.
11Glader, EL, Stegmayr, B, Asplund, K.Poststroke fatigue: a 2-year follow-up study of stroke patients in Sweden. Stroke. 2002; 33(5):132733.
12Choi-Kwon, S, Han, SW, Kwon, SU, Kim, JS.Poststroke fatigue: characteristics and related factors. Cerebrovasc Dis. 2005;19 (2):8490.
13Naess, H, Nyland, HI, Thomassen, L, Aarseth, J, Myhr, KM.Fatigue at long-term follow-up in young adults with cerebral infarction. Cerebrovasc Dis. 2005;20(4):24550.
14Lerdal, A, Bakken, LN, Kouwenhoven, SE, et al.Poststroke fatigue - a review. J Pain Symptom Manage. 2009;38(6):92849.
15Reid, JM, Gubitz, GJ, Dai, D, et al.External validation of a six simple variable model of stroke outcome and verification in hyper-acute stroke. J Neurol Neurosurg Psychiatry. 2007;78(12): 13901.
16Rigby, H, Gubitz, G, Eskes, G, et al.Caring for stroke survivors: baseline and 1-year determinants of caregiver burden. Int J Stroke. 2009;4(3):1528.
17Reid, JM, Gubitz, GJ, Dai, D, et al.Predicting functional outcome after stroke by modeling baseline clinical and CT variables. Age Ageing. 2010;39(3):3606.
18Reid, JM, Dai, D, Christian, C, et al.Developing predictive models of excellent and devastating outcome after stroke. Age Ageing. 2012;41(4):5604.
19Statistics Canada Canadian 2001 Census. CHASS (distributer). Accessed Oct 10, 2011 at http://dc1.chass.utoronto.ca.ezproxy.library.dal.ca/census/2001_fed_as.html
20Aho, K, Harmsen, P, Hatano, S, Marquardsen, J, Smirnov, VE, Strasser, T.Cerebrovascular disease in the community: results of a WHO collaborative study. Bull World Health Organ. 1980;58(1): 11330.
21Bamford, JM, Sandercock, PA, Warlow, CP, Slattery, J.Interobserver agreement for the assessment of handicap in stroke patients. Stroke. 1989;20(6):828.
22Counsell, C, Dennis, M, McDowall, M, Warlow, C.Predicting outcome after acute and subacute stroke: development and validation of new prognostic models. Stroke. 2002;33(4):10417.
23Weir, NU, Counsell, CE, McDowall, M, Gunkel, A, Dennis, MS.Reliability of the variables in a new set of models that predict outcome after stroke. J Neurol Neurosurg Psychiatry. 2003;74 (4):44751.
24EC/IC Bypass Study Group. The international cooperative study of extracranial/intracranial arterial anastomosis: methodology and entry characteristics. Stroke. 1985;16(3):397406.
25Bamford, J, Sandercock, P, Dennis, M, Burn, J, Warlow, C.Classification and natural history of clinically identifiable subtypes of cerebral infarction. Lancet. 1991;337(8756):15216.
26Mahoney, FI, Barthel, DW.Functional evaluation: the barthel index. Md State Med J. 1965;14:615.
27Rankin, J.Cerebral vascular accidents in patients over the age of 60. II. Prognosis. Scott Med J. 1957;2(5):20015.
28van Swieten, JC, Koudstaal, PJ, Visser, MC, Schouten, HJ, van Gijn, J.interobserver agreement for the assessment of handicap in stroke patients. Stroke. 1988;19(5):6047.
29Wood-Dauphinee, S, Williams, JI.Reintegration to normal living as a proxy to quality of life. J Chronic Dis. 1987;40(6):491502.
30Yesavage, JA, Brink, TL, Rose, TL, et al.Development and validation of a geriatric depression screening scale: a preliminary report. J psychiatr Res. 1982-1983:17(1):3749.
31Fisk, JD, Pontefract, A, Ritvo, PG, Archibald, CJ, Murray, TJ.The impact of fatigue on patients with multiple sclerosis. Can J Neurol Sci. 1994;21(1):914.
32Roding, J, Lindstrom, B, Malm, J, Ohman, A.Frustrated and invisible-younger stroke patients’ experiences of the rehabilitation process. Disabil Rehabil. 2003;25(15):86774.
33Bendz, M.The first year of rehabilitation after a stroke - from two perspectives. Scand J Caring Sci. 2003;17(3):21522.
34Mead, G, Lynch, J, Greig, C, Young, A, Lewis, S, Sharpe, M.Evaluation of fatigue scales in stroke patients. Stroke. 2007;38 (7):20905.
35Schepers, VP, Visser-Meily, AM, Ketelaar, M, Lindeman, E.Poststroke fatigue: course and its relation to personal and stroke-related factors. Arch Phys Med Rehabil. 2006;87(2):1848.
36Tang, WK, Chen, YK, Mok, V, et al.Acute basal ganglia infarcts in poststroke fatigue: an MRIs study. J Neurol. 2010;257(2):17882.
37Sisson, RA.Cognitive status as a predictor of right hemisphere stroke outcomes. J Neurosci Nurs. 1995;27(3):1526.
38American Psychiatric Association. Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author, 2000.
39Beck, AT, Steer, RA, Brown, GK.Manual for the Beck Depression Inventor-II. San Antonio, TX.Psychological Corporation: 1996.
40Hedlund, JL, Vieweg, BW.The Hamilton rating scale for depression: a comprehensive review. J Operational Psych. 1979;10:14965.
41McGeough, E, Pollock, A, Smith, LN, et al.Interventions for poststroke fatigue. Cochrane Database Syst Rev. 2009;3:CD007030.
42Zedlitz, AM, Rietveld, TC, Geurts, AC, Fasotti, L.Cognitive and graded activity training can alleviate persistent fatigue after stroke: a randomized, controlled trial. Stroke. 2012;43(4): 104651.
43Brainin, M, Pinter, M.Poststroke fatigue: a hint, but no definite word on therapy yet. Stroke. 2012;43(4):9334.

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed