Physical impairment, depressive symptoms and pre-stroke fatigue are related to fatigue in the acute phase after stroke

Abstract

Purpose: The aim of this study was to describe prevalence of fatigue and its relationship with demographic and clinical variables during the first 2 weeks (acute phase) following a stroke.

Method: Data were collected in a cross-sectional correlational study from face-to-face interviews using structured questionnaires and patient's medical records. The sample consists of 115 patients with first-ever stroke admitted to two hospitals in Norway in 2007 and 2008. Post-stroke fatigue was measured with the Fatigue Severity Scale (FSS). The FSS measure was applied in the analysis as a continuous variable, and also used to categorise patients into three groups of fatigue intensity: no fatigue (mean FSS-score <4), moderate fatigue (mean FSS-score = 4-4.9) and severe fatigue (mean FSS-score ≥5). Patients who reported fatigue lasting longer than 3 months before the stroke were defined as having prestroke fatigue.

Results: Pre-stroke fatigue was reported by 34 patients (30%). After stroke, 24% had severe fatigue, and fatigue was more common for women (57%). Controlling for sex and prestroke fatigue, the multivariate analysis showed that prestroke fatigue, lower physical function and depressive symptoms were related to post-stroke fatigue.

Conclusion: Pre-stroke fatigue and fatigue during the acute phase needs to be assessed in relation to physical functioning and depression during recovery and the rehabilitation process.