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Lazeron-Savu E, Lenaert B, Dijkstra J, Ponds R, van Heugten C. Feasibility of a novel blended-care intervention for fatigue after acquired brain injury: a pilot study of the Tied by Tiredness intervention. Brain Inj 2024; 38:448-458. [PMID: 38324645 DOI: 10.1080/02699052.2024.2311346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 01/24/2024] [Indexed: 02/09/2024]
Abstract
PURPOSE Evidence-based treatments for fatigue after brain injury are scarce and often not personalized. An approach to foster personalization is Experience Sampling Methodology (ESM), consisting of repeated daily measurements of fatigue and related factors in daily life. We investigated the feasibility and usability of a novel six-week ESM-based intervention for fatigue after brain injury. MATERIALS AND METHODS Ten individuals with acquired brain injury (six men; four women) aged between 36-70 years (M = 53.3, SD = 12.9) used a mHealth application for three days each week during six-weeks; seven completed the intervention. Momentary fatigue, activities, mood, worrying, and social context were assessed with ESM and participants received weekly personalized feedback by a therapist.. RESULTS 56% of ESM-questionnaires (568/1008) were completed, providing detailed insights into individual fatigue patterns. No statistically significant decrease in response rate was found over the course of treatment. Qualitative feedback from participants revealed increased insight into factors underlying fatigue, and no problems with treatment duration or difficulties using the app. Five participants showed a decline in fatigue level during treatment. CONCLUSIONS This pilot study provides initial support for the feasibility and usability of this novel blended-care intervention, aimed at alleviating fatigue through personalized feedback and treatment strategies.
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Affiliation(s)
- Ela Lazeron-Savu
- School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Department of Medical Psychology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Bert Lenaert
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Department of Lifespan Psychology, Faculty of Psychology, Open University, Heerlen, The Netherlands
| | - Jeanette Dijkstra
- School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Department of Medical Psychology, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Rudolf Ponds
- School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Limburg Brain Injury Center, Maasticht University, Maastricht, The Netherlands
- Department of Medical Psychology, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Caroline van Heugten
- School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Limburg Brain Injury Center, Maasticht University, Maastricht, The Netherlands
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Klinkhammer S, Duits AA, Deckers K, Horn J, Slooter AJC, Verwijk E, van Heugten CM, Visser-Meily JMA. A Biopsychosocial Approach to Persistent Post-COVID-19 Fatigue and Cognitive Complaints: Results of the Prospective Multicenter NeNeSCo Study. Arch Phys Med Rehabil 2024; 105:826-834. [PMID: 38228250 DOI: 10.1016/j.apmr.2023.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 12/21/2023] [Accepted: 12/28/2023] [Indexed: 01/18/2024]
Abstract
OBJECTIVE To evaluate whether psychological and social factors complement biomedical factors in understanding post-COVID-19 fatigue and cognitive complaints. Additionally, to incorporate objective (neuro-cognitive) and subjective (patient-reported) variables in identifying factors related to post-COVID-19 fatigue and cognitive complaints. DESIGN Prospective, multicenter cohort study. SETTING Six Dutch hospitals. PARTICIPANTS 205 initially hospitalized (March-June 2020), confirmed patients with SARS-CoV-2, aged ≥18 years, physically able to visit the hospital, without prior cognitive deficit, magnetic resonance imaging (MRI) contraindication, or severe neurologic damage post-hospital discharge (N=205). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Nine months post-hospital discharge, a 3T MRI scan and cognitive testing were performed and patients completed questionnaires. Medical data were retrieved from medical dossiers. Hierarchical regression analyses were performed on fatigue severity (Fatigue Severity Scale; FSS) and cognitive complaints (Cognitive Consequences after Intensive Care Admission; CLC-IC; dichotomized into CLC-high/low). Variable blocks: (1) Demographic and premorbid factors (sex, age, education, comorbidities), (2) Illness severity (ICU/general ward, PROMIS physical functioning [PROMIS-PF]), (3) Neuro-cognitive factors (self-reported neurological symptoms, MRI abnormalities, cognitive performance), (4) Psychological and social factors (Hospital Anxiety and Depression Scale [HADS], Utrecht Coping List, Social Support List), and (5) Fatigue or cognitive complaints. RESULTS The final models explained 60% (FSS) and 48% (CLC-IC) variance, with most blocks (except neuro-cognitive factors for FSS) significantly contributing. Psychological and social factors accounted for 5% (FSS) and 11% (CLC-IC) unique variance. Higher FSS scores were associated with younger age (P=.01), lower PROMIS-PF (P<.001), higher HADS-Depression (P=.03), and CLC-high (P=.04). Greater odds of CLC-high were observed in individuals perceiving more social support (OR=1.07, P<.05). CONCLUSIONS Results show that psychological and social factors add to biomedical factors in explaining persistent post-COVID-19 fatigue and cognitive complaints. Objective neuro-cognitive factors were not associated with symptoms. Findings highlight the importance of multidomain treatment, including psychosocial care, which may not target biologically-rooted symptoms directly but may reduce associated distress.
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Affiliation(s)
- Simona Klinkhammer
- School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands; Limburg Brain Injury Center, Maastricht University, Maastricht, the Netherlands
| | - Annelien A Duits
- School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands; Department of Medical Psychology, Maastricht University Medical Center, Maastricht, the Netherlands; Department of Medical Psychology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Kay Deckers
- School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands
| | - Janneke Horn
- Department of Intensive Care, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands; Amsterdam Neuroscience, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Arjen J C Slooter
- UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands; Department of Intensive Care Medicine, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands; Department of Neurology, UZ Brussel and Vrije Universiteit Brussel, Brussels Health Campus, Jette, Belgium
| | - Esmée Verwijk
- Amsterdam Neuroscience, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands; Department of Medical Psychology, Amsterdam University Medical Center, Amsterdam, the Netherlands; Department of Psychology, Brain and Cognition, University of Amsterdam, Amsterdam, the Netherlands
| | - Caroline M van Heugten
- School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands; Limburg Brain Injury Center, Maastricht University, Maastricht, the Netherlands; Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands.
| | - Johanna M A Visser-Meily
- Department of Rehabilitation, Physical Therapy Science & Sports, University Medical Center Utrecht, Utrecht, the Netherlands; Center of Excellence for Rehabilitation Medicine and De Hoogstraat Rehabilitation, University Medical Center Utrecht, Utrecht, the Netherlands
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Smejka T, Verberne D, Schepers J, Wolfs C, Schepers V, Ponds R, Van Heugten C. Trajectories of fatigue and related outcomes following mild acquired brain injury: a multivariate latent class growth analysis. J Rehabil Med 2024; 56:jrm32394. [PMID: 38506428 PMCID: PMC10985494 DOI: 10.2340/jrm.v56.32394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 03/05/2024] [Indexed: 03/21/2024] Open
Abstract
OBJECTIVE Fatigue is a common symptom following acquired brain injury although the severity and course differs for many individuals. This longitudinal study aimed to identify latent trajectory classes of fatigue and associated outcomes following mild brain injury. METHODS 204 adults with mild traumatic brain injury (159; 78%) or minor stroke (45; 22%) were assessed 4 times over 1 year. Subjective measures of fatigue, anxiety, depression, cognitive complaints and societal participation were collected. Multivariate Latent Class Growth Analysis identified classes of participants with similar longitudinal patterns. Demographic and injury characteristics were used to predict class membership. RESULTS Analysis revealed four classes. Class 1 (53%) had mild, decreasing fatigue with no other problems. Class 2 (29%) experienced high persistent fatigue, moderate cognitive complaints and societal participation problems. Class 3 (11%) had high persistent fatigue with anxiety, depression, cognitive complaints and participation problems. Class 4 (7%) experienced decreasing fatigue with anxiety and depression but no cognitive or participation problems. Women and older individuals were more likely to be in class 2. CONCLUSION Half the participants had a favourable outcome while the remaining classes were characterised by persistent fatigue with cognitive complaints (class 2), decreasing fatigue with mood problems (class 4) or fatigue with both cognitive and mood problems (class 3). Fatigue treatment should target combinations of problems in such individual trajectories after mild brain injury.
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Affiliation(s)
- Tom Smejka
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands; Limburg Brain Injury Centre, the Netherlands
| | - Daan Verberne
- Department of Neurorehabilitation, Sint Maartenskliniek, Nijmegen, the Netherlands
| | - Jan Schepers
- Department of Methodology and Statistics, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Claire Wolfs
- Limburg Brain Injury Centre, the Netherlands; School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Vera Schepers
- Department of Rehabilitation, Physical Therapy Science and Sports, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Rudolf Ponds
- Limburg Brain Injury Centre, the Netherlands; School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands; Department of Medical Psychology, Amsterdam University Medical Center, location VU, Amsterdam, the Netherlands
| | - Caroline Van Heugten
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands; Limburg Brain Injury Centre, the Netherlands.
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Abelmann AC, Kessels RPC, Brazil IA, Fasotti L, Bertens D. Game-supported cognitive strategy training for slowed information processing speed after acquired brain injury: study protocol for a randomised controlled trial. BMJ Open 2023; 13:e067108. [PMID: 37734890 PMCID: PMC10514599 DOI: 10.1136/bmjopen-2022-067108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 08/24/2023] [Indexed: 09/23/2023] Open
Abstract
INTRODUCTION Many individuals with acquired brain injury tend to experience problems with slowed information processing speed (IPS). A potentially beneficial and cost-effective supplement for cognitive rehabilitation of impaired IPS may be the implementation of serious gaming that focuses on compensatory learning as part of cognitive training. However, most digital platforms used during cognitive rehabilitation focus on restoring cognitive function and evidence for skill transfer from digital practice to everyday life is lacking. This study aims to investigate the efficacy of a game-supported cognitive strategy training. The training combines a well-validated time pressure management cognitive strategy training, targeting slowed IPS, with a novel game and a mobile application. The game-supported training focuses on the generalisation of strategy-use to untrained tasks in everyday life. METHODS AND ANALYSIS The study is designed as a randomised controlled trial in which the experimental group (Karman Line - Tempo module: an 8-week game-supported cognitive strategy training) will be compared with an active control group (CogniPlus training: an 8-week computerised cognitive function training). Data from 60 individuals with acquired brain injury (30 per group, ages between 16 and 75) will be collected at baseline (T0), post-treatment (T1) and at 3-month follow-up (T2). The primary outcome measure is an objective assessment of compensatory strategy use in an untrained experimental task. The secondary outcome is the attainment of trained and untrained treatment goals assessed by goal attainment scaling. Pre-training and post-training data will be analysed using a 2×2 repeated measure analysis of variance. ETHICS AND DISSEMINATION This study has been approved by the medical review ethics committee CMO Region Arnhem and Nijmegen (NL74818.091.20) and is registered in the Netherlands Trial Register. Research findings will be published in peer-reviewed journals and presented at conferences. TRIAL REGISTRATION NUMBER NL9437; The Netherlands Trial Register.
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Affiliation(s)
- Amy C Abelmann
- Neuropsychology and Rehabilitation Psychology, Radboud University Donders Institute for Brain Cognition and Behaviour, Nijmegen, The Netherlands
- Research and Innovation, Klimmendaal, Arnhem, The Netherlands
| | - Roy P C Kessels
- Neuropsychology and Rehabilitation Psychology, Radboud University Donders Institute for Brain Cognition and Behaviour, Nijmegen, The Netherlands
- Research and Innovation, Klimmendaal, Arnhem, The Netherlands
| | - Inti A Brazil
- Neuropsychology and Rehabilitation Psychology, Radboud University Donders Institute for Brain Cognition and Behaviour, Nijmegen, The Netherlands
- Division Diagnostics, Pompestichting Langdurige Forensisch Psychiatrische Zorg, Nijmegen, The Netherlands
| | - Luciano Fasotti
- Neuropsychology and Rehabilitation Psychology, Radboud University Donders Institute for Brain Cognition and Behaviour, Nijmegen, The Netherlands
- Research and Innovation, Klimmendaal, Arnhem, The Netherlands
| | - Dirk Bertens
- Neuropsychology and Rehabilitation Psychology, Radboud University Donders Institute for Brain Cognition and Behaviour, Nijmegen, The Netherlands
- Research and Innovation, Klimmendaal, Arnhem, The Netherlands
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Dornonville de la Cour FL, Norup A, Andersen TE, Schow T. Defining a Treatment Model for Self-Management of Fatigue in Rehabilitation of Acquired Brain Injury Using the Rehabilitation Treatment Specification System. J Clin Med 2023; 12:jcm12093192. [PMID: 37176631 PMCID: PMC10179474 DOI: 10.3390/jcm12093192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 04/17/2023] [Accepted: 04/26/2023] [Indexed: 05/15/2023] Open
Abstract
Systematic treatment descriptions to standardize and evaluate management of fatigue after acquired brain injury (ABI) are lacking. The purpose of this multi-phase qualitative study was to formulate a treatment model for promoting self-management of fatigue in rehabilitation of ABI based on practice-based understandings and routines. The study was conducted in a community-based rehabilitation center in Denmark. The model was defined using the Rehabilitation Treatment Specification System. Phase 1 comprised co-production workshops with five service providers (occupational therapists, physiotherapists, and a neuropsychologist) to elicit preliminary treatment theories. In Phase 2, four case studies were conducted on management of fatigue in vocational rehabilitation. Interviews (n = 8) and treatment log entries (n = 76) were analyzed thematically to specify treatment targets and active ingredients. The treatment model comprised five main components: (i) Knowledge and understanding of fatigue, (ii) Interoceptive attention of fatigue, (iii) Acceptance of fatigue, (iv) Activity management, and (v) Self-management of fatigue. For each component, lists of targets and active ingredients are outlined. In conclusion, management of fatigue includes multiple treatment components addressing skills, habits, and mental representations such as knowledge and attitudes. The model articulates treatment theories, which may guide clinical reasoning and facilitate future theory-driven evaluation research.
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Affiliation(s)
| | - Anne Norup
- Neurorehabilitation Research and Knowledge Centre, Rigshospitalet, 2600 Glostrup, Denmark
| | | | - Trine Schow
- Cervello, 2800 Kongens Lyngby, Denmark
- Neurorehabilitation Research and Knowledge Centre, Rigshospitalet, 2600 Glostrup, Denmark
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Verschuren O, Benner JL, Balemans ACJ, Horemans H, Van Den Berg-Emons RJG, Van Der Slot WMA. Real-time daily fatigue, sleep, physical activity, and health-related fitness in adults with cerebral palsy. Dev Med Child Neurol 2023; 65:509-516. [PMID: 36155917 DOI: 10.1111/dmcn.15421] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 08/29/2022] [Accepted: 09/02/2022] [Indexed: 11/29/2022]
Abstract
AIM To explore whether subgroups of adults with cerebral palsy (CP) with different fatigue diurnal profiles can be discerned, and to explore whether sleep, physical activity, or health-related fitness are associated with these profiles. METHOD Thirty-two adults (median age 29 years 8 months; range 20-54 years; 11 males, 21 females) with spastic CP (Gross Motor Function Classification System levels I-III) with physical activity-related fatigue complaints participated. Real-time fatigue and physical activity were assessed for 7 consecutive days by short message service text four times during the day and by wearing an accelerometer respectively. Sleep was assessed by the Pittsburgh Sleep Quality Index, and fitness by assessing body composition and aerobic capacity. Latent class growth modelling was used to classify subgroups according to their diurnal profiles of real-time fatigue. Univariable multinomial logistic regression analysis explored whether participant characteristics, sleep, physical activity, or health-related fitness were associated with diurnal profiles. RESULTS Three distinct fatigue diurnal profiles were identified: stable low (n = 10), increasing (n = 14), and stable high (n = 8). Only aerobic capacity was associated with fatigue profiles (odds ratio 1.15, 95% confidence interval 1.00-1.34; p = 0.05). INTERPRETATION Fatigue in adults with CP may be low or high stable or may increase during the day. These findings indicate the relevance of assessing fatigue variability. WHAT THIS PAPER ADDS We found three patterns of daily fatigue in adults with cerebral palsy (CP). Only aerobic capacity was associated with fatigue profiles in adults with CP. Moment-to-moment variations in fatigue can help with personalized fatigue management.
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Affiliation(s)
- Olaf Verschuren
- Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
| | - Joyce L Benner
- Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, and Rijndam Rehabilitation, Rotterdam, the Netherlands
| | - Astrid C J Balemans
- Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
- Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, and Rijndam Rehabilitation, Rotterdam, the Netherlands
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam Public Health, Amsterdam UMC, Amsterdam, the Netherlands
| | - Herwin Horemans
- Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, and Rijndam Rehabilitation, Rotterdam, the Netherlands
| | - Rita Johanna G Van Den Berg-Emons
- Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, and Rijndam Rehabilitation, Rotterdam, the Netherlands
| | - Wilma M A Van Der Slot
- Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, and Rijndam Rehabilitation, Rotterdam, the Netherlands
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Dornonville de la Cour FL, Schow T, Andersen TE, Petersen AH, Zornhagen G, Visser-Keizer AC, Norup A. Measurement Properties of the Dutch Multifactor Fatigue Scale in Early and Late Rehabilitation of Acquired Brain Injury in Denmark. J Clin Med 2023; 12:jcm12072587. [PMID: 37048671 PMCID: PMC10094862 DOI: 10.3390/jcm12072587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/27/2023] [Accepted: 03/28/2023] [Indexed: 04/01/2023] Open
Abstract
Fatigue is a major issue in neurorehabilitation without a gold standard for assessment. The purpose of this study was to evaluate measurement properties of the five subscales of the self-report questionnaire the Dutch Multifactor Fatigue Scale (DMFS) among Danish adults with acquired brain injury. A multicenter study was conducted (N = 149, 92.6% with stroke), including a stroke unit and three community-based rehabilitation centers. Unidimensionality and measurement invariance across rehabilitation settings were tested using confirmatory factor analysis. External validity with Depression Anxiety Stress Scales (DASS-21) and the EQ-5D-5L was investigated using correlational analysis. Results were mixed. Unidimensionality and partial invariance were supported for the Impact of Fatigue, Mental Fatigue, and Signs and Direct Consequences of Fatigue, range: RMSEA = 0.07–0.08, CFI = 0.94–0.99, ω = 0.78–0.90. Coping with Fatigue provided poor model fit, RMSEA = 0.15, CFI = 0.81, ω = 0.46, and Physical Fatigue exhibited local dependence. Correlations among the DMFS, DASS-21, and EQ-5D-5L were in expected directions but in larger magnitudes compared to previous research. In conclusion, three subscales of the DMFS are recommended for assessing fatigue in early and late rehabilitation, and these may facilitate the targeting of interventions across transitions in neurorehabilitation. Subscales were strongly interrelated, and the factor solution needs evaluation.
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Affiliation(s)
- Frederik Lehman Dornonville de la Cour
- Cervello, 2800 Kongens Lyngby, Denmark
- Department of Psychology, University of Southern Denmark, 5230 Odense, Denmark
- Correspondence: ; Tel.: +45-38634628
| | | | | | | | - Gry Zornhagen
- Center for Communication Disorders, The Capital Region of Denmark, 2750 Ballerup, Denmark
| | | | - Anne Norup
- Department of Psychology, University of Southern Denmark, 5230 Odense, Denmark
- Neurorehabilitation Research and Knowledge Centre, Rigshospitalet, 2600 Glostrup, Denmark
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Ramnarain D, Den Oudsten B, Oldenbeuving A, Pouwels S, De Vries J. Post-Intensive Care Syndrome in Patients Suffering From Acute Subarachnoid Hemorrhage: Results From an Outpatient Post-ICU Aftercare Clinic. Cureus 2023; 15:e36739. [PMID: 37123775 PMCID: PMC10139679 DOI: 10.7759/cureus.36739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2023] [Indexed: 03/29/2023] Open
Abstract
Introduction Survivors of an acute subarachnoid hemorrhage (aSAH) may suffer from a long-term neurological disability, cognitive impairment, anxiety, and depression, which can also be related to post-intensive care syndrome (PICS). The aim of this study was to examine the prevalence of PICS symptoms in post-intensive care (ICU) aftercare aSAH patients. Methods We conducted an observational cohort study in aSAH patients from a post-ICU aftercare clinic (ICU-AC). PICS symptoms were evaluated using the Impact of Event Scale-Revised (IES-R), Hospital Anxiety and Depression Scale (HADS), and a medical questionnaire for physical and cognitive functioning. Results A total of 110 patients were included. The prevalence of anxiety and depressive symptoms was 23.6% and 19.1%, respectively. Post-traumatic stress disorder (PTSD) was seen in 26.4%. Cognitive complaints were lack of concentration (63.6%), short-term memory loss (45.8%), and reduced speed of thinking (60.9%). The most reported physical complaints were fatigue (73.6%), limitations in daily activity (72.7%), muscle weakness (41.8%), pain (36.4%), and weight loss (30.9%). PICS symptoms related to all three domains were present in 30% of patients. Conclusion The prevalence of PICS in patients after aSAH is high. Even in patients without aSAH-related neurological impairment who were discharged home, a high prevalence of PICS symptoms was reported. Early screening for PICS should comprise all three domains and is important to facilitate a better tailored rehabilitation of these patients.
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Vinke JS, Eisenga MF, Sanders JSF, Berger SP, Spikman JM, Abdulahad WH, Bakker SJ, Gaillard CAJM, van Zuilen AD, van der Meer P, de Borst MH. Effect of Intravenous Ferric Carboxymaltose on Exercise Capacity After Kidney Transplantation (EFFECT-KTx): rationale and study protocol for a double-blind, randomised, placebo-controlled trial. BMJ Open 2023; 13:e065423. [PMID: 36948568 PMCID: PMC10040026 DOI: 10.1136/bmjopen-2022-065423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/24/2023] Open
Abstract
INTRODUCTION Iron deficiency (ID) is common and has been associated with an excess mortality risk in kidney transplant recipients (KTRs). In patients with chronic heart failure and ID, intravenous iron improves exercise capacity and quality of life. Whether these beneficial effects also occur in KTRs is unknown. The main objective of this trial is to address whether intravenous iron improves exercise tolerance in iron-deficient KTRs. METHODS AND ANALYSIS The Effect of Ferric Carboxymaltose on Exercise Capacity after Kidney Transplantation study is a multicentre, double-blind, randomised, placebo-controlled clinical trial that will include 158 iron-deficient KTRs. ID is defined as plasma ferritin <100 µg/L or plasma ferritin 100-299 µg/L with transferrin saturation <20%. Patients are randomised to receive 10 mL of ferric carboxymaltose (50 mg Fe3+/mL, intravenously) or placebo (0.9% sodium chloride solution) every 6 weeks, four dosages in total. The primary endpoint is change in exercise capacity, as quantified by the 6 min walk test, between the first study visit and the end of follow-up, 24 weeks later. Secondary endpoints include changes in haemoglobin levels and iron status, quality of life, systolic and diastolic heart function, skeletal muscle strength, bone and mineral parameters, neurocognitive function and safety endpoints. Tertiary (explorative) outcomes are changes in gut microbiota and lymphocyte proliferation and function. ETHICS AND DISSEMINATION The protocol of this study has been approved by the medical ethical committee of the University Medical Centre Groningen (METc 2018/482;) and is being conducted in accordance with the principles of the Declaration of Helsinki, the Standard Protocol Items: Recommendations for Interventional Trials checklist and the Good Clinical Practice guidelines provided by the International Council for Harmonization of Technical Requirements for Pharmaceuticals for Human Use. Study results will be disseminated through publications in peer-reviewed journals and conference presentations. TRIAL REGISTRATION NUMBER NCT03769441.
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Affiliation(s)
- Joanna Sj Vinke
- Department of Nephrology, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
| | - Michele F Eisenga
- Department of Nephrology, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
| | - Jan-Stephan F Sanders
- Department of Nephrology, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
| | - Stefan P Berger
- Department of Nephrology, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
| | - Jacoba M Spikman
- Department of Neuropsychology, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
| | - Wayel H Abdulahad
- Department of Immunology, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
| | - Stephan Jl Bakker
- Department of Nephrology, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
| | - Carlo A J M Gaillard
- Department of Nephrology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Arjan D van Zuilen
- Department of Nephrology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - P van der Meer
- Department of Cardiology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Martin H de Borst
- Department of Nephrology, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
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Ford ME, Geurtsen GJ, Groet E, Rambaran Mishre RD, Van Bennekom CAM, Van Someren EJW. A blended eHealth intervention for insomnia following acquired brain injury: a randomised controlled trial. J Sleep Res 2023; 32:e13629. [PMID: 35641443 PMCID: PMC10078387 DOI: 10.1111/jsr.13629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 04/05/2022] [Accepted: 04/14/2022] [Indexed: 02/03/2023]
Abstract
The high prevalence and severe consequences of poor sleep following acquired brain injury emphasises the need for an effective treatment. However, treatment studies are scarce. The present study evaluates the efficacy of blended online cognitive behavioural therapy for insomnia (eCBT-I) developed specifically for people with acquired brain injury. In a multicentre prospective, open-label, blinded end-point randomised clinical trial, 52 participants with insomnia and a history of a stroke or traumatic brain injury were randomised to 6 weeks of guided eCBT-I or treatment as usual, with a 6-week follow-up. The primary outcome measure was the change in insomnia severity between baseline and after treatment, measured with the Insomnia Severity Index. Results showed that insomnia severity improved significantly more with eCBT-I than with treatment as usual compared to baseline, both at post-treatment (mean [SEM] 4.0 [1.3] insomnia severity index points stronger decrease, d = 0.96, p < 0.003) and at follow-up (mean [SEM] 3.2 [1.5] insomnia severity index points, d = -0.78, p < 0.03). In conclusion, our randomised clinical trial shows that blended CBT is an effective treatment for insomnia, and feasible for people with acquired brain injury, regardless of cognitive and psychiatric complaints. Online treatment has major advantages in terms of availability and cost and may contribute to the successful implementation of insomnia treatment for people with acquired brain injuries.
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Affiliation(s)
- Marthe E Ford
- Research and Development, Heliomare Rehabilitation, Wijk aan Zee, the Netherlands.,Departments of Integrative Neurophysiology and Psychiatry, Amsterdam UMC, VU University, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Gert J Geurtsen
- Department of Medical Psychology, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands.,Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands
| | - Erny Groet
- Research and Development, Heliomare Rehabilitation, Wijk aan Zee, the Netherlands
| | | | - Coen A M Van Bennekom
- Research and Development, Heliomare Rehabilitation, Wijk aan Zee, the Netherlands.,Coronel Institute for Labor and Health, Amsterdam UMC, location AMC, Amsterdam, the Netherlands
| | - Eus J W Van Someren
- Departments of Integrative Neurophysiology and Psychiatry, Amsterdam UMC, VU University, Amsterdam Neuroscience, Amsterdam, the Netherlands.,Department of Sleep and Cognition, Netherlands Institute for Neuroscience, Amsterdam, the Netherlands
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11
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Pilon L, Frankenmolen NF, van der Zijp J, Kessels RP, Bertens D. A short add-on sleep intervention in the rehabilitation of individuals with acquired brain injury: A randomized controlled trial. NeuroRehabilitation 2023; 53:323-334. [PMID: 37694314 PMCID: PMC10657700 DOI: 10.3233/nre-230139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 08/13/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND Sleep disturbances are common after acquired brain injury (ABI) and have a negative impact on functioning. OBJECTIVE This study examines whether a short add-on therapy for sleep disturbances in individuals with ABI is effective in addition to rehabilitation treatment as usual. METHODS In the randomized-controlled study, 54 adults with ABI and self-reported sleep disturbances receiving outpatient rehabilitation services were randomized in two groups: one receiving a sleep intervention (based on cognitive behavioural therapy for insomnia (CBT-I)) in addition to their rehabilitation treatment (CBT-I + TAU group) and one receiving treatment as usual (TAU). The primary outcome was sleep quality, measured with the Pittsburgh Sleep Quality Index (PSQI). Secondary outcomes included measures of anxiety, depression, fatigue and dysfunctional beliefs and attitudes about sleep. RESULTS The short add-on sleep therapy resulted in improvements in sleep quality in the CBT-I + TAU group as compared to the TAU group (ES = 0.924). Furthermore, the CBT-I + TAU group reported less dysfunctional beliefs and attitudes about sleep and were better able to cope with fatigue compared to the TAU group. CONCLUSIONS The application of this short add-on sleep intervention could be implemented in neuropsychological rehabilitation settings.
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Affiliation(s)
- Louise Pilon
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands
- Rehabilitation Medical Centre Klimmendaal, Arnhem, The Netherlands
| | - Nikita F. Frankenmolen
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Rehabilitation Medical Centre Klimmendaal, Arnhem, The Netherlands
| | | | - Roy P.C. Kessels
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands
- Rehabilitation Medical Centre Klimmendaal, Arnhem, The Netherlands
| | - Dirk Bertens
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Rehabilitation Medical Centre Klimmendaal, Arnhem, The Netherlands
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12
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Ali A, Morfin J, Mills J, Pasipanodya EC, Maas YJ, Huang E, Dirlikov B, Englander J, Zedlitz A. Fatigue After Traumatic Brain Injury: A Systematic Review. J Head Trauma Rehabil 2022; 37:E249-E257. [PMID: 34354018 DOI: 10.1097/htr.0000000000000710] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To provide a systematic review of published interventions for posttraumatic brain injury fatigue (PTBIF). METHODS PubMed and OneSearch were systematically searched for PTBIF interventions published between January 1, 1989, and March 31, 2019. Search results were evaluated for inclusion based on an abstract and full-text review. Inclusion criteria were (1) an investigation of an intervention, (2) participant sample including individuals with traumatic brain injury (TBI), (3) report of fatigue outcome data among individuals with TBI, and (4) articles available in English, Spanish, French, German, Afrikaans, or Dutch. A risk of bias assessment was conducted on all included publications. RESULTS The search resulted in 2343 publications, with 37 meeting inclusion criteria for this review. Categories of PTBIF interventions were pharmacological ( n = 13), psychological ( n = 9), exercise-based ( n = 4), complementary alternative medicine ( n = 5), electrotherapeutic ( n = 3), and multimodal ( n = 3). Only methylphenidate, modafinil, and cognitive behavioral therapy interventions included multiple cohorts. Pharmacological and psychological interventions represented the groups with the lowest risk of bias. CONCLUSIONS This review includes 37 studies, with 21 studies published after 2014. Methylphenidate and melatonin were the only pharmacological agents found to reduce fatigue in randomized controlled trials. Creatine given to children prospectively at onset of injury reduced fatigue at follow-up. Walking and water aerobics were effective exercise interventions in isolated randomized controlled studies. One multimodal study of children after concussion was more effective at reducing fatigue and postconcussion symptoms than community standard of care. Other interventions had equivocal results. Overall, more work remains to understand and develop treatments for PTBIF.
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Affiliation(s)
- Arshad Ali
- Rehabilitation Research Center, Santa Clara Valley Medical Center, San Jose, California (Messrs Ali and Dirlikov, Ms Morfin, and Dr Pasipanodya); Medical Library, Santa Clara Valley Medical Center, San Jose, California (Ms Mills); SeneCure, GGZ-Breburg, Tilburg, the Netherlands (Ms Maas); Physical Medicine and Rehabilitation Department, Santa Clara Valley Medical Center, San Jose, California (Drs Huang and Englander); Department of Orthopedic Surgery, Stanford University School of Medicine, Palo Alto, California (Dr Englander); and Institute of Psychology, Health, Medical and Neuropsychology Unit, Leiden University, Leiden, the Netherlands (Dr Zedlitz)
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13
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Dornonville de la Cour FL, Bærentzen MB, Forchhammer B, Tibæk S, Norup A. Reducing fatigue following acquired brain injury: A feasibility study of high intensity interval training for young adults. Dev Neurorehabil 2022; 25:349-360. [PMID: 35343359 DOI: 10.1080/17518423.2022.2052374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The aim was to evaluate feasibility of high-intensity interval training (HIIT) in fatigued adults (20-40 years old) with acquired brain injury (ABI). A prospective pre-post single-arm intervention trial was conducted, including 6-8 months follow-up assessment and interview. Intervention was 18 sessions of intermittent exercise on a cycle ergometer over six weeks. Six out of ten participants without motor impairments completed the intervention (all females, mean age = 30.2 years, months post-injury = 22). On average, participants attended 88% of sessions and achieved high intensity (93% of max heart rate). VO2max improved by 0.53 l/min (SD = 0.29), and participants continued exercising post-intervention. All participants were satisfied with HIIT, were more inclined to exercise, and reported positive effects of exercising for self-management of fatigue. Three sessions a week were demanding to some participants. Findings support feasibility of HIIT as a promising intervention for young adults with post-ABI fatigue.
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Affiliation(s)
| | | | | | - Sigrid Tibæk
- Department of Occupation Therapy and Physiotherapy, University of Copenhagen, Rigshospitalet Glostrup, Glostrup, Denmark
| | - Anne Norup
- Neurorehabilitation Research and Knowledge Centre, Rigshospitalet, Copenhagen, Denmark
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14
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Díaz-García J, González-Ponce I, Ponce-Bordón JC, López-Gajardo MÁ, Ramírez-Bravo I, Rubio-Morales A, García-Calvo T. Mental Load and Fatigue Assessment Instruments: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:419. [PMID: 35010678 PMCID: PMC8744873 DOI: 10.3390/ijerph19010419] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 12/23/2021] [Accepted: 12/28/2021] [Indexed: 11/23/2022]
Abstract
Mental load and fatigue are important causes of performance decreases and accidents in different activities. However, a robust systematic review, detailing the instruments used to quantify them, is currently lacking. The purpose of this study was to summarize and classify by derivations the validated instruments used to quantify mental load and fatigue. The most representative electronic databases in the scope of this review, PubMed, WOS, Scopus, SPORTDiscus, and PsycINFO (until September 2020) were searched for studies that included instruments to analyze mental load and fatigue. The quality of the selected studies was scored using a quality assessment checklist. A total of 40 papers were included. Most of the papers used subjective scales (75%) to quantify mental load and fatigue, with a small presence of behavioral (n = 5) and objective techniques (n = 5). Less is known about the analysis of mental load and fatigue using a combination of derivations. Despite the high cost and complexity of objective techniques, research that applies these measures is important for further analysis of brain processes in mental load and fatigue. The design of a battery of tests that include the three types of derivations also seems necessary.
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Affiliation(s)
- Jesús Díaz-García
- Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain; (J.D.-G.); (J.C.P.-B.); (M.Á.L.-G.); (I.R.-B.); (A.R.-M.); (T.G.-C.)
| | | | - José Carlos Ponce-Bordón
- Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain; (J.D.-G.); (J.C.P.-B.); (M.Á.L.-G.); (I.R.-B.); (A.R.-M.); (T.G.-C.)
| | - Miguel Ángel López-Gajardo
- Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain; (J.D.-G.); (J.C.P.-B.); (M.Á.L.-G.); (I.R.-B.); (A.R.-M.); (T.G.-C.)
| | - Iván Ramírez-Bravo
- Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain; (J.D.-G.); (J.C.P.-B.); (M.Á.L.-G.); (I.R.-B.); (A.R.-M.); (T.G.-C.)
| | - Ana Rubio-Morales
- Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain; (J.D.-G.); (J.C.P.-B.); (M.Á.L.-G.); (I.R.-B.); (A.R.-M.); (T.G.-C.)
| | - Tomás García-Calvo
- Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain; (J.D.-G.); (J.C.P.-B.); (M.Á.L.-G.); (I.R.-B.); (A.R.-M.); (T.G.-C.)
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15
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Dornonville de la Cour FL, Norup A, Schow T, Andersen TE. Evaluation of Response Processes to the Danish Version of the Dutch Multifactor Fatigue Scale in Stroke Using the Three-Step Test-Interview. Front Hum Neurosci 2021; 15:642680. [PMID: 34025374 PMCID: PMC8134536 DOI: 10.3389/fnhum.2021.642680] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 03/23/2021] [Indexed: 11/13/2022] Open
Abstract
Validated self-report measures of post-stroke fatigue are lacking. The Dutch Multifactor Fatigue Scale (DMFS) was translated into Danish, and response process evidence of validity was evaluated. DMFS consists of 38 Likert-rated items distributed on five subscales: Impact of fatigue (11 items), Signs and direct consequences of fatigue (9), Mental fatigue (7), Physical fatigue (6), and Coping with fatigue (5). Response processes to DMFS were investigated using a Three-Step Test-Interview (TSTI) protocol, and data were analyzed using Framework Analysis. Response processes were indexed on the following categories: (i) "congruent," response processes were related to the subscale construct; (ii) "incongruent," response processes were not related to the subscale construct; (iii) "ambiguous," response processes were both congruent and incongruent or insufficient to evaluate congruency; and (iv) "confused," participants did not understand the item. Nine adults were recruited consecutively 10-34 months post-stroke (median = 26.5) at an outpatient brain injury rehabilitation center in 2019 [five females, mean age = 55 years (SD = 6.3)]. Problematic items were defined as <50% of response processes being congruent with the intended construct. Of the 38 items, five problematic items were identified, including four items of Physical fatigue and one of Mental fatigue. In addition, seven items posed various response difficulties to some participants due to syntactic complexity, vague terms, a presupposition, and a double-barrelled statement. In conclusion, findings elucidate the interpretative processes involved in responding to DMFS post-stroke, strengthen the evidence base of validity, and guide revisions to mitigate potential problems in item performance.
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Affiliation(s)
- Frederik L Dornonville de la Cour
- BOMI Brain Injury Rehabilitation Center, Roskilde, Denmark.,Department of Psychology, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Anne Norup
- Department of Psychology, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.,Neurorehabilitation Research and Knowledge Centre, Rigshospitalet, Copenhagen, Denmark
| | - Trine Schow
- BOMI Brain Injury Rehabilitation Center, Roskilde, Denmark
| | - Tonny Elmose Andersen
- Department of Psychology, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
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16
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Ford ME, Geurtsen GJ, Groet E, Van Bennekom CAM, Van Someren EJW. A blended eHealth intervention for insomnia following acquired brain injury: study protocol for a randomized controlled trial. Trials 2020; 21:861. [PMID: 33066812 PMCID: PMC7566121 DOI: 10.1186/s13063-020-04789-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 10/05/2020] [Indexed: 11/10/2022] Open
Abstract
Background Up to a third of stroke patients and patients with traumatic brain injury suffer from insomnia, including problems to fall asleep or stay asleep at night. Insomnia may exacerbate other brain damage-related problems, for example regarding cognitive functioning and emotional well-being; may lead to poorer quality of life; and may complicate recovery processes. Cognitive behavioral therapy for insomnia, delivered face-to-face or online, is found to be effective in the general population. However, despite the high prevalence and serious consequences of insomnia following acquired brain injury, studies on the efficacy of face-to-face cognitive behavioral treatment in this population are scarce, and this applies even more for studies on online cognitive behavioral therapy. Therefore, this study aims to evaluate the efficacy of a newly developed guided online cognitive behavioral therapy for insomnia following acquired brain injury. Methods A multicenter, prospective, randomized, open-label, blinded end point study (PROBE) will be conducted, in which 48 patients diagnosed with stroke or traumatic brain injury and insomnia will be randomly allocated to the online cognitive behavioral therapy for insomnia treatment group or the treatment as usual group. The treatment consists of 6 online cognitive behavioral therapy sessions given on a weekly basis and personalized feedback after each session, combined with 2 face-to-face sessions. Outcomes will be assessed at baseline, immediately after the intervention period and at 6-week follow-up. The primary outcome is the insomnia severity assessed with the Insomnia Severity Index. Secondary outcome measures include sleep quality, sleep features derived from the sleep diary, fatigue, anxiety and depression, subjective cognitive functioning, and societal participation. Discussion This study will provide insight on the efficacy of online cognitive behavioral therapy for insomnia following stroke and traumatic brain injury. Trial registration Netherlands Trial Register NTR7082. Registered on 12 March 2018.
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Affiliation(s)
- Marthe E Ford
- Department of Psychology, Heliomare Rehabilitation, Wijk aan Zee, The Netherlands.
| | - Gert J Geurtsen
- Department of Medical Psychology, Amsterdam UMC, location AMC, Amsterdam, The Netherlands
| | - Erny Groet
- Department of Psychology, Heliomare Rehabilitation, Wijk aan Zee, The Netherlands.,Research and Development, Heliomare Rehabilitation, Wijk aan Zee, The Netherlands
| | - Coen A M Van Bennekom
- Department of Medical Psychology, Amsterdam UMC, location AMC, Amsterdam, The Netherlands.,Coronel Institute for Labor and Health /Amsterdam UMC, location AMC, Amsterdam, The Netherlands
| | - Eus J W Van Someren
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, Amsterdam, The Netherlands.,Departments of Integrative Neurophysiology and Psychiatry, Amsterdam UMC, VU University, Amsterdam Neuroscience, Amsterdam, The Netherlands
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17
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Defining the content of a minimal dataset for acquired brain injury using a Delphi procedure. Health Qual Life Outcomes 2020; 18:30. [PMID: 32066447 PMCID: PMC7027079 DOI: 10.1186/s12955-020-01286-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 02/10/2020] [Indexed: 12/17/2022] Open
Abstract
Background The lack of consistency in outcome measurement within the field of acquired brain injury (ABI) leads to incomparability of collected data and, consequently, reduced generalisation of findings. We aim to develop a set of standardised measures which can be used to obtain the minimum amount of data necessary to characterise ABI-patients across all healthcare sectors and disciplines and in every stage of recovery; i.e., an ABI-specific minimal dataset (MDS-ABI). The current study was conducted to identify the core outcome domains for adults with ABI (what to measure?) and to select the most suitable measurements within these domains (how to measure it?). Methods An initial comprehensive set of outcome domains and measurement instruments relevant for measuring the consequences of ABI was identified by a literature study. The selection of relevant domains was based on the International Classification of Functioning, Disability and Health framework. Measurement instruments were included in the Delphi procedure when they met pre-set requirements. A three-round Delphi study was conducted among Dutch experts (n = 48) using iterative web-based surveys to prioritise the proposed domains and instruments for the MDS-ABI. Throughout all rounds, participants could recommend additional or alternative domains and measurement instruments, and were fed back the collated group responses of the previous round. Results Response rates ranged from 89 to 100%. After three rounds, the expert panel reached consensus (≥51%) on the inclusion of 12 outcome domains (demographics, injury characteristics, comorbidity, cognitive functioning, emotional functioning, energy, mobility, self-care, communication, participation, social support and quality of life), measured with six measurement instruments, two screening questions and a registry of demographic- and injury information. No consensus was reached on how to measure quality of life. Conclusions The current study achieved consensus on the content of a minimal dataset for patients with ABI. The current version of the MDS-ABI will be evaluated and optimised if necessary in the near future.
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18
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Ezekiel L, Field L, Collett J, Dawes H, Boulton M. Experiences of fatigue in daily life of people with acquired brain injury: a qualitative study. Disabil Rehabil 2020; 43:2866-2874. [DOI: 10.1080/09638288.2020.1720318] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Leisle Ezekiel
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
- Oxford Institute of Nursing, Midwifery and Allied Health Research, Oxford, UK
| | - Leanne Field
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Johnny Collett
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
- Oxford Institute of Nursing, Midwifery and Allied Health Research, Oxford, UK
| | - Helen Dawes
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
- Oxford Institute of Nursing, Midwifery and Allied Health Research, Oxford, UK
| | - Mary Boulton
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
- Oxford Institute of Nursing, Midwifery and Allied Health Research, Oxford, UK
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19
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Spreij LA, Sluiter D, Gosselt IK, Visser-Meily JMA, Nijboer TCW. CoCo - participation: The development and clinical use of a novel inventory measuring cognitive complaints in daily life. Neuropsychol Rehabil 2019; 31:255-277. [PMID: 31790631 DOI: 10.1080/09602011.2019.1691017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Cognitive difficulties can be subtle and only come to light when patients return home from inpatient care and start to participate in society. Subjective cognitive complaints often interfere with participation, hence capturing cognitive complaints systematically is important. We developed a patient- and relative-reported measure to assess cognitive complaints during daily life activities across the memory, attention and executive domain for patients with acquired brain injury (ABI). The inventory Cognitive Complaints - Participation (CoCo-P) was created based on a literature review, consultations with experts, semi-structured interviews with patients, and a quantitative study. The inventory was administered to patients with ABI (n = 46), their relatives (n = 33) and healthy controls (n = 102) to finalize the inventory. We examined the reported complaints per daily life activity and cognitive domain of patients and healthy controls, and we compared the patients' and relatives' reports. The majority of patients (87-96%) experienced cognitive complaints, mostly related to attention, at work/education, during leisure activities, and in contact with family/friends and community. Patients reported more cognitive complaints than relatives. The CoCo-P seems appropriate to capture cognitive complaints in daily life in patients with mild ABI. Additional research is needed in terms of reliability and validity.
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Affiliation(s)
- Lauriane A Spreij
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, Netherlands
| | - David Sluiter
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, Netherlands.,Department of Rehabilitation, Physical Therapy Science & Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Netherlands
| | - Isabel K Gosselt
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, Netherlands
| | - Johanna M A Visser-Meily
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, Netherlands.,Department of Rehabilitation, Physical Therapy Science & Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Netherlands
| | - Tanja C W Nijboer
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, Netherlands.,Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, Netherlands
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20
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Lack of content overlap and essential dimensions - A review of measures used for post-stroke fatigue. J Psychosom Res 2019; 124:109759. [PMID: 31443803 DOI: 10.1016/j.jpsychores.2019.109759] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 06/19/2019] [Accepted: 06/30/2019] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Post-stroke fatigue (PSF) is a highly prevalent and disabling condition. A major obstacle in PSF research is the lack of consensus on how to assess and diagnose fatigue after stroke. A wide variety of patient reported outcome measures (PROMs) are currently being used, none of which are developed specifically for stroke patients. The objectives of this study are to evaluate content validity in individual fatigue PROMs, and to identify similarities and differences through cross-comparison of PROMs. METHODS We used a novel mixed-methods approach to evaluate content validity in fatigue PROMs. First, we performed a qualitative content analysis of items in eleven fatigue PROMs used in stroke populations, and then we used descriptive statistics and a similarity coefficient to investigate similarities and differences across instruments. RESULTS The analysis of 156 items in eleven PROMs revealed 83 different items each representing a distinct attribute of fatigue. The results show that currently used fatigue PROMs omit important PSF-specific items, do not take into account the multidimensional nature of PSF and lack content overlap. SUMMARY The wide variety of items and lack of overlap between fatigue PROMs illuminates the need for researchers to report why a specific PROM was used. PROMs that capture the specific experiences of patients with PSF are also needed to advance research on PSF and its etiology and treatment.
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21
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Bruijel J, Stapert SZ, Vermeeren A, Ponsford JL, van Heugten CM. Unraveling the Biopsychosocial Factors of Fatigue and Sleep Problems After Traumatic Brain Injury: Protocol for a Multicenter Longitudinal Cohort Study. JMIR Res Protoc 2018; 7:e11295. [PMID: 30348629 PMCID: PMC6231738 DOI: 10.2196/11295] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 07/05/2018] [Accepted: 07/06/2018] [Indexed: 01/19/2023] Open
Abstract
Background Fatigue and sleep problems are common after a traumatic brain injury (TBI) and are experienced as highly distressing symptoms, playing a significant role in the recovery trajectory, and they can drastically impact the quality of life and societal participation of the patient and their family and friends. However, the etiology and development of these symptoms are still uncertain. Objective The aim of this study is to examine the development of fatigue and sleep problems following moderate to severe TBI and to explore the changes in underlying biological (pain, brain damage), psychological (emotional state), and social (support family, participation) factors across time. Methods This study is a longitudinal multicenter observational cohort study with 4 measurement points (3, 6, 12, and 18 months postinjury) including subjective questionnaires and cognitive tasks, preceded by 7 nights of actigraphy combined with a sleep diary. Recruitment of 137 moderate to severe TBI patients presenting at emergency and neurology departments or rehabilitation centers across the Netherlands is anticipated. The evolution of fatigue and sleep problems following TBI and their association with possible underlying biological (pain, brain damage), psychological (emotional state), and social (support family, participation) factors will be examined. Results Recruitment of participants for this longitudinal cohort study started in October 2017, and the enrollment of participants is ongoing. The first results are expected at the end of 2020. Conclusions To the authors’ knowledge, this is the first study that examines the development of both post-TBI fatigue and sleep longitudinally within a biopsychosocial model in moderate to severe TBI using both subjective and objective measures. Identification of modifiable factors such as mood and psychosocial stressors may give direction to the development of interventions for fatigue and sleep problems post-TBI. Trial Registration Netherlands Trial Register NTR7162; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=7162 (Archived by WebCite at http://www.webcitation.org/6z3mvNLuy) International Registered Report Identifier (IRRID) RR1-10.2196/11295
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Affiliation(s)
- Jessica Bruijel
- Department of Neuropsychology & Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands.,Limburg Brain Injury Centre, Maastricht, Netherlands
| | - Sven Z Stapert
- Department of Neuropsychology & Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands.,Limburg Brain Injury Centre, Maastricht, Netherlands.,Department of Clinical and Medical Psychology, Zuyderland Medical Centre, Sittard-Geleen, Netherlands
| | - Annemiek Vermeeren
- Department of Neuropsychology & Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Jennie L Ponsford
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Australia.,Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Melbourne, Australia
| | - Caroline M van Heugten
- Department of Neuropsychology & Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands.,Limburg Brain Injury Centre, Maastricht, Netherlands.,School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University Medical center, Maastricht, Netherlands
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22
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Dornonville de la Cour FL, Forchhammer BH, Mogensen J, Norup A. On the relation between dimensions of fatigue and depression in adolescents and young adults with acquired brain injury. Neuropsychol Rehabil 2018; 30:872-887. [DOI: 10.1080/09602011.2018.1517368] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Frederik L. Dornonville de la Cour
- National study of young brain injury survivors, Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- The Unit for Cognitive Neuroscience (UCN), Department of Psychology, University of Copenhagen, Copenhagen, Denmark
- Brain Injury Center BOMI, Roskilde, Denmark
| | - Birgitte H. Forchhammer
- National study of young brain injury survivors, Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Jesper Mogensen
- The Unit for Cognitive Neuroscience (UCN), Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Anne Norup
- National study of young brain injury survivors, Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
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23
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Buunk AM, Groen RJM, Wijbenga RA, Ziengs AL, Metzemaekers JDM, van Dijk JMC, Spikman JM. Mental versus physical fatigue after subarachnoid hemorrhage: differential associations with outcome. Eur J Neurol 2018; 25:1313-e113. [PMID: 29924481 PMCID: PMC6221080 DOI: 10.1111/ene.13723] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 06/19/2018] [Indexed: 12/02/2022]
Abstract
Background and purpose Fatigue is a major consequence of subarachnoid hemorrhage (SAH), but the specific characteristics are unclear. Our objective was to investigate the nature of post‐SAH fatigue (mental or physical) and to determine the relationship with functional outcome in the chronic stage. Also, the possible influence of mood disorders and acute SAH‐related factors [SAH type and external cerebrospinal fluid (CSF) drainage] on the presence of fatigue was investigated. Methods Patients with an aneurysmal SAH (aSAH) or angiographically negative SAH (anSAH) were assessed 3–10 years post‐SAH (N = 221). Questionnaires were used to investigate mental and physical fatigue and mood. Functional outcome was examined with the Glasgow Outcome Scale Extended. Between‐group comparisons and binary logistic regression analysis were performed. Results Frequencies of mental and physical fatigue were 48.4% and 38.5%, respectively, with prevalence of mental fatigue being significantly higher. A two‐way anova with SAH type and external CSF drainage as independent variables and mental fatigue as dependent variable showed a significant main effect of CSF drainage only (P < 0.001). Only mental fatigue explained a significant part of the variance in long‐term functional outcome (model χ2 = 52.99, P < 0.001; Nagelkerke R² = 0.32). Conclusions Mental fatigue after SAH is a serious burden to the patient and is associated with impaired long‐term functional outcome. Distinguishing different aspects of fatigue is relevant as mental post‐SAH fatigue might be a target for treatment aimed to improve long‐term outcome.
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Affiliation(s)
- A M Buunk
- Department of Neurology, Subdepartment of Neuropsychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - R J M Groen
- Department of Neurosurgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - R A Wijbenga
- Department of Neurology, Subdepartment of Neuropsychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - A L Ziengs
- Department of Neurology, Subdepartment of Neuropsychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - J D M Metzemaekers
- Department of Neurosurgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - J M C van Dijk
- Department of Neurosurgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - J M Spikman
- Department of Neurology, Subdepartment of Neuropsychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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24
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Douven E, Köhler S, Schievink SHJ, van Oostenbrugge RJ, Staals J, Verhey FRJ, Aalten P. Temporal Associations between Fatigue, Depression, and Apathy after Stroke: Results of the Cognition and Affect after Stroke, a Prospective Evaluation of Risks Study. Cerebrovasc Dis 2017; 44:330-337. [PMID: 29073590 DOI: 10.1159/000481577] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 09/07/2017] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Poststroke fatigue (PSF) is a form of pathological fatigue that can develop after stroke and has a negative impact on functional outcome. PSF is associated with poststroke depression (PSD), which in turn shows similarities with poststroke apathy (PSA). This study aimed at disentangling the temporal associations between PSF and PSD and between PSF and PSA. METHODS A total of 250 stroke patients were included, of which 243 completed the Fatigue Severity Scale, Montgomery-Åsberg Depression Rating Scale, and Apathy Evaluation Scale at 3 months poststroke, with follow-up measurements at 6 and 12 months after initial testing. Linear mixed models and linear regressions were performed to evaluate the temporal associations between PSF and PSD, and between PSF and PSA. RESULTS PSF was present in 119 patients (49%), of whom 62 patients also had PSD (26%), and 21 patients (9%) also had PSA. At baseline, PSF patients showed higher depression levels, which remained stable at follow-up. PSD patients had higher fatigue levels compared with no-PSD patients at baseline, which remained stable at follow-up. No association between apathy and fatigue was found at baseline and no interaction with time was found. Change in fatigue from baseline to 12-month follow-up was associated with change in depression and with change in apathy. CONCLUSIONS Bidirectional associations were found between PSF and PSD. In treatment and rehabilitation programs, early focus on the presence of PSD and PSF is important, since these conditions tend to persist. As there are currently more treatment options for PSD, attention for PSD is important and might also have a beneficial effect on PSF.
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Affiliation(s)
- Elles Douven
- Department of Psychiatry and Neuropsychology, Maastricht University, School for Mental Health and Neuroscience (MHeNs), Alzheimer Center Limburg, Maastricht, the Netherlands
| | - Sebastian Köhler
- Department of Psychiatry and Neuropsychology, Maastricht University, School for Mental Health and Neuroscience (MHeNs), Alzheimer Center Limburg, Maastricht, the Netherlands
| | - Syenna H J Schievink
- Department of Psychiatry and Neuropsychology, Maastricht University, School for Mental Health and Neuroscience (MHeNs), Alzheimer Center Limburg, Maastricht, the Netherlands
| | - Robert J van Oostenbrugge
- Department of Neurology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center (MUMC+), Maastricht, the Netherlands
| | - Julie Staals
- Department of Neurology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center (MUMC+), Maastricht, the Netherlands
| | - Frans R J Verhey
- Department of Psychiatry and Neuropsychology, Maastricht University, School for Mental Health and Neuroscience (MHeNs), Alzheimer Center Limburg, Maastricht, the Netherlands
| | - Pauline Aalten
- Department of Psychiatry and Neuropsychology, Maastricht University, School for Mental Health and Neuroscience (MHeNs), Alzheimer Center Limburg, Maastricht, the Netherlands
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25
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Kolakowsky-Hayner SA, Bellon K, Toda K, Bushnik T, Wright J, Isaac L, Englander J. A randomised control trial of walking to ameliorate brain injury fatigue: a NIDRR TBI model system centre-based study. Neuropsychol Rehabil 2016; 27:1002-1018. [PMID: 27733079 DOI: 10.1080/09602011.2016.1229680] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Fatigue is one of the most commonly reported sequelae after traumatic brain injury (TBI). This study evaluated the impact of a graduated physical activity programme on fatigue after TBI. Using a prospective randomised single-blind crossover design, 123 individuals with TBI, over the age of 18, were enrolled. Interventions included a home-based walking programme utilising a pedometer to track daily number of steps at increasing increments accompanied by tapered coaching calls over a 12-week period. Nutritional counselling with the same schedule of coaching calls served as the control condition. Main outcome measures included: the Global Fatigue Index (GFI), the Barrow Neurological Institute (BNI) Fatigue Scale Overall Severity Index Score, and the Multidimensional Fatigue Inventory (MFI). Step counts improved over time regardless of group assignment. The walking intervention led to a decrease in GFI, BNI Total, and MFI General scores. Participants reported less fatigue at the end of the active part of the intervention (24 weeks) and after a wash out period (36 weeks) as measured by the BNI Overall. The study suggests that walking can be used as an efficient and cost-effective tool to improve fatigue in persons who have sustained a TBI.
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Affiliation(s)
- Stephanie A Kolakowsky-Hayner
- a Department of Physical Medicine and Rehabilitation , Santa Clara Valley Medical Center , San Jose , CA , USA.,b Brain Trauma Foundation , New York, NY and Campbell, CA , USA
| | - Kimberly Bellon
- a Department of Physical Medicine and Rehabilitation , Santa Clara Valley Medical Center , San Jose , CA , USA
| | - Ketra Toda
- a Department of Physical Medicine and Rehabilitation , Santa Clara Valley Medical Center , San Jose , CA , USA
| | - Tamara Bushnik
- c NYU Langone School of Medicine , Rusk Institute for Rehabilitation Medicine , New York , NY , USA
| | - Jerry Wright
- a Department of Physical Medicine and Rehabilitation , Santa Clara Valley Medical Center , San Jose , CA , USA
| | - Linda Isaac
- a Department of Physical Medicine and Rehabilitation , Santa Clara Valley Medical Center , San Jose , CA , USA
| | - Jeffrey Englander
- a Department of Physical Medicine and Rehabilitation , Santa Clara Valley Medical Center , San Jose , CA , USA.,d Division of Physical Medicine and Rehabilitation in Department of Orthopedic Surgery , Stanford University School of Medicine , Stanford , CA , USA
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26
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de Koning ME, Gareb B, El Moumni M, Scheenen ME, van der Horn HJ, Timmerman ME, Spikman JM, van der Naalt J. Subacute posttraumatic complaints and psychological distress in trauma patients with or without mild traumatic brain injury. Injury 2016; 47:2041-7. [PMID: 27297705 DOI: 10.1016/j.injury.2016.04.036] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Revised: 04/05/2016] [Accepted: 04/22/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To identify the frequency, nature and profile of complaints for trauma patients with and without mild traumatic brain injury (mTBI), and to assess their relation to anxiety and depression. METHODS A prospective cohort study in a level-one trauma centre was conducted. Mild traumatic brain injury patients and trauma controls were approached for participation. Two weeks after injury, The Head Injury Symptom Checklist (HISC) and the Hospital Anxiety and Depression Scale (HADS) were administered. RESULTS Two-hundred seventy two patients with mTBI and 125 TC patients completed the questionnaires. Differences were demonstrated between the two trauma populations on frequency and nature of reported complaints. Ordinal common factor analysis on the mTBI scores yielded three factors: mental distress, physical discomfort, and sensory disbalance, which were all significantly correlated to anxiety and depression scores. Discriminant analyses identified a subset of complaints which could allocate almost 80% of patients to the correct group. CONCLUSIONS Patients with mTBI showed a different pattern of complaints than orthopaedic control patients. A mental distress factor consisting of both somatic and cognitive complaints proved to be most discriminating and showed high correlations with anxiety and depression.
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Affiliation(s)
- M E de Koning
- Department of Neurology, University of Groningen, University Medical Center Groningen, The Netherlands
| | - B Gareb
- Department of Trauma Surgery, University of Groningen, University Medical Center Groningen, The Netherlands
| | - M El Moumni
- Department of Trauma Surgery, University of Groningen, University Medical Center Groningen, The Netherlands
| | - M E Scheenen
- Department of Clinical Neuropsychology, University of Groningen, University Medical Center Groningen, The Netherlands
| | - H J van der Horn
- Department of Neurology, University of Groningen, University Medical Center Groningen, The Netherlands
| | - M E Timmerman
- Department of Psychometrics and Statistics, University of Groningen, University Medical Center Groningen, The Netherlands
| | - J M Spikman
- Department of Clinical Neuropsychology, University of Groningen, University Medical Center Groningen, The Netherlands
| | - J van der Naalt
- Department of Neurology, University of Groningen, University Medical Center Groningen, The Netherlands.
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27
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van Markus-Doornbosch F, de Kloet AJ, Berger MAM, Lambregts SAM, Wolterbeek R, Vliet Vlieland TPM. Factors related to fatigue after paediatric acquired brain injury (ABI). Brain Inj 2016; 30:1533-1541. [DOI: 10.1080/02699052.2016.1197968] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
| | - A. J. de Kloet
- Sophia Rehabilitation, The Hague, The Netherlands
- The Hague University of Applied Sciences, The Hague, The Netherlands
| | - M. A. M. Berger
- The Hague University of Applied Sciences, The Hague, The Netherlands
| | - S. A. M. Lambregts
- Revant Rehabilitation Centre, Breda, The Netherlands
- Department of Rehabilitation Medicine, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - R. Wolterbeek
- Department of Medical Statistics, Leiden University Medical Centre, Leiden, The Netherlands
| | - T. P. M. Vliet Vlieland
- Sophia Rehabilitation, The Hague, The Netherlands
- Department of Orthopaedics, Leiden University Medical Centre, Rehabilitation and Physical Therapy, Leiden, The Netherlands
- Rijnlands Rehabilitation Centre, Leiden, The Netherlands
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28
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Schow T, Teasdale TW, Quas KJ, Rasmussen MA. Problems with balance and binocular visual dysfunction are associated with post-stroke fatigue. Top Stroke Rehabil 2016; 24:41-49. [PMID: 27267094 DOI: 10.1080/10749357.2016.1188475] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Fatigue after stroke is hard to define and measure and how it is associated with other complications after stroke still needs to be explored. These issues are relevant in stroke rehabilitation and in the patient's daily life. OBJECTIVE To investigate fatigue after stroke and its relation to balance, gait, and Binocular Visual Dysfunction (BVD). METHODS Adults with stroke (n = 29, age 18-67 years) were tested with the Modified Fatigue Impact Scale (MFIS), objective and subjective BVD measures, Balance Evaluation Systems Test, Ten Meter Walk Test, and a Health-Related Quality of Life questionnaire, before and after a four-month intervention program and at three- and six-month follow-ups. We used principle component analysis to extract underlying factors of MFIS. Associations between MFIS factors and patient characteristics were analyzed by repeated measures ANOVA. The associations between MFIS factors and physical measures were assessed using pairwise correlations. RESULTS Three components were extracted from the MFIS, explaining 71% of variance: Cognitive fatigue, Physical fatigue and Arousal. We found that women register higher MFIS scores than men. There was a strong association between the level of Cognitive and Physical Fatigue and BVD, between Arousal and balance and dizziness, and between Cognitive Fatigue and gait. CONCLUSION The three extracted components of MFIS proved clinically informative. The arousal component revealed particularly interesting results in studying fatigue. The correlation analysis shown at this component differs from cognitive and physical fatigue and describes another aspect of PSF, important in future treatment and research.
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Affiliation(s)
- Trine Schow
- a Brain Injury Center - BOMI , Roskilde , Denmark
| | | | | | - Morten Arendt Rasmussen
- c Faculty of Science , Spectroscopy and Chemometrics University of Copenhagen , Frederiksberg , Denmark.,d Danish Paediatric Asthma Centre , Gentofte Hospital, University of Copenhagen , Copenhagen , Denmark
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