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Ni X, Shi J, Hu Q, Li A, Zeng X, Gu Y. Sedentary behaviour among elderly patients after total knee arthroplasty and its influencing factors. Sci Rep 2024; 14:14278. [PMID: 38902382 PMCID: PMC11190212 DOI: 10.1038/s41598-024-64836-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Accepted: 06/13/2024] [Indexed: 06/22/2024] Open
Abstract
To understand the status of sedentary behaviour in elderly patients after total knee arthroplasty and analyse its influencing factors so as to provide a reference for developing targeted interventions. Conveniently selected elderly patients undergoing total knee arthroplasty (> 6 months) in a tertiary hospital in Jiangsu Province were investigated using a general information questionnaire, the Charlson Comorbidity Index, patients' self-reported sedentary behaviour information, the WOMAC Score, The Groningen Orthopaedic Social Support Scale, and Lee's Fatigue. The median daily sedentary time was 5.5 h (4.5 h, 6.625 h) in 166 elderly patients after total knee arthroplasty, of whom 82 (49.40%) showed sedentary behaviour (≥ 6 h per day). Logistic regression analysis showed that being retired/unemployed (OR = 8.550, 95% CI 1.732-42.207, P = 0.0084), having a CCI score ≥ 3 (OR = 9.018, 95% CI 1.288-63.119, P < 0.0001), having high WOMAC scores (OR = 1.783, 95% CI 1.419-2.238, P < 0.0001), having a high social support score (OR = 1.155, 95% CI 1.031-1.294, P = 0.0130), and having a fatigue score ≥ 5 (OR = 4.848, 95% CI 1.084-21.682, P = 0.0389) made patients more likely to be sedentary. The sedentary time of elderly patients after total knee arthroplasty is long, and sedentary behaviour is common among them. Healthcare professionals should develop targeted sedentary behaviour interventions based on the influencing factors of sedentary behaviour in order to reduce the occurrence of sedentary behaviour in elderly patients after total knee arthroplasty.
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Affiliation(s)
- Xuan Ni
- Department of Orthopedics, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, Jiangsu, 211100, China
| | - Juan Shi
- Department of Orthopedics, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, Jiangsu, 211100, China
| | - Qing Hu
- Department of Orthopedics, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, Jiangsu, 211100, China.
| | - Ai Li
- Nursing Department, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xing Zeng
- Department of Gastrointestinal Oncology Surgery, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yajing Gu
- Department of Urology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, Jiangsu, China
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2
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Lohaus T, Witt J, Schürmeyer A, Wolf OT, Thoma P. Fatigue and its relation to general cognition, social cognition and social activity in multiple sclerosis and stroke. Cogn Neuropsychiatry 2023; 28:165-180. [PMID: 36782396 DOI: 10.1080/13546805.2023.2178399] [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: 02/15/2023]
Abstract
INTRODUCTION The relationship between fatigue and (socio-)cognitive deficits in neurological diseases has sparked increasing research interest in the past years. So far, findings are inconsistent. Most studies focused on general cognitive functioning in specific disorders, particularly cancer or multiple sclerosis (MS). METHODS This study aims to examine the relationship between fatigue, social cognition and social activity, also taking into account general cognition, more closely, including a stroke patient group (n = 57), a MS patient group (n = 31) and a healthy control group (n = 20). The participants underwent a comprehensive (socio-)cognitive test battery and completed questionnaires on fatigue and psychopathology which, in addition to fatigue, can also affect (socio-)cognitive performance. RESULTS In both MS and stroke patients high fatigue scores were observed. Irrespective of aetiology, patients with high and low fatigue did not differ with regard to general cognition and social cognition. However, high fatigue scores were associated with a reduction of social activities in both patient groups. No other significant relationships were observed between fatigue and (socio-)cognitive measures. CONCLUSIONS Future studies ought to further explore the potentially complex nature of fatigue symptoms and their relationship with (socio-)cognitive performance and social activity in neurological populations.
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Affiliation(s)
- Tobias Lohaus
- Neuropsychological Therapy Centre (NTC), Faculty of Psychology, Ruhr University Bochum, Bochum, Germany
| | - Judith Witt
- Neuropsychological Therapy Centre (NTC), Faculty of Psychology, Ruhr University Bochum, Bochum, Germany
| | - Anne Schürmeyer
- Practice for Neuropsychology and Psychotherapy, Bochum, Germany
| | - Oliver T Wolf
- Department of Cognitive Psychology, Institute of Cognitive Neuroscience, Faculty of Psychology, Ruhr University Bochum, Bochum, Germany
| | - Patrizia Thoma
- Neuropsychological Therapy Centre (NTC), Faculty of Psychology, Ruhr University Bochum, Bochum, Germany
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3
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Kirchberger I, Wallner F, Linseisen J, Zickler P, Ertl M, Naumann M, Meisinger C. Factors Associated With Early and Late Post-stroke Fatigue in Patients With Mild Impairment. Results From the Stroke Cohort Study Augsburg. Front Neurol 2022; 13:852486. [PMID: 35359631 PMCID: PMC8964017 DOI: 10.3389/fneur.2022.852486] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 02/16/2022] [Indexed: 11/13/2022] Open
Abstract
Background Post-stroke fatigue is a common symptom after stroke. However, studies on the factors associated with early and late fatigue are scarce. The objective of this study was to identify variables associated with early and late fatigue. Methods In the German Stroke Cohort Augsburg (SCHANA) study, participants were interviewed during their hospital stay and completed a postal questionnaire 3 and 12 months post-stroke. Fatigue was assessed using the Fatigue Assessement Scale (FAS). In addition, depression was measured by the Patient Health Questionnaire (PHQ-9), general health status by the EQ-5D visual analog scale, and physical activity by the International Physical Activity Questionnaire (IPAQ). Multivariable regression models were used to determine the associations between FAS scores at 3 and 12 months post-stroke and demographic, psychosocial and health-related covariables. Results Among 505 participants, the frequency of fatigue was 31.1% 3 months and 29.1% 12 months post-stroke. Prior stroke (ß = 2.37, p = 0.0076), prior diagnosis of depression (ß = 5.04, p = 0.0001), higher NIHSS (ß = 0.25, p = 0.0360) and higher PHQ-9 scores (ß = 0.55, p < 0.0001) were significantly associated with higher fatigue levels 3 months post-stroke. Additionally, younger age (ß = -0.07, p = 0.0219), a worse rating of general health at baseline (ß = -0.04, p = 0.0287) and low pre-stroke physical activity (ß = -0.0004, p = 0.0089) were significantly associated with higher fatigue levels 12 months after stroke. Conclusions Fatigue is a common and persisting symptom even in patients with mild impairment. Prior depressive disorder and early depressive symptoms were the most relevant predictors of both early and late fatigue.
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Affiliation(s)
- Inge Kirchberger
- Chair of Epidemiology at the University Augsburg, University Hospital Augsburg, Augsburg, Germany.,Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians Universität Munich, Munich, Germany.,Independent Research Group Clinical Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
| | - Florian Wallner
- Chair of Epidemiology at the University Augsburg, University Hospital Augsburg, Augsburg, Germany.,Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians Universität Munich, Munich, Germany.,Pettenkofer School of Public Health, Munich, Germany
| | - Jakob Linseisen
- Chair of Epidemiology at the University Augsburg, University Hospital Augsburg, Augsburg, Germany.,Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians Universität Munich, Munich, Germany.,Independent Research Group Clinical Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
| | - Philipp Zickler
- Department of Neurology and Clinical Neurophysiology, University Hospital Augsburg, Augsburg, Germany
| | - Michael Ertl
- Department of Neurology and Clinical Neurophysiology, University Hospital Augsburg, Augsburg, Germany
| | - Markus Naumann
- Department of Neurology and Clinical Neurophysiology, University Hospital Augsburg, Augsburg, Germany
| | - Christine Meisinger
- Chair of Epidemiology at the University Augsburg, University Hospital Augsburg, Augsburg, Germany
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Ren W, Wu J, Wu Z, Yang S, Jiang X, Xu M, Wu B, Xie C, He J, Yu X. Serum Uric Acid Levels at Admission Could Predict the Chronic Post-stroke Fatigue. Front Nutr 2022; 9:850355. [PMID: 35273991 PMCID: PMC8902642 DOI: 10.3389/fnut.2022.850355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 01/31/2022] [Indexed: 11/13/2022] Open
Abstract
Background Post-stroke fatigue (PSF) is a frequent complication of stroke. Serum uric acid (SUA) is frequently thought to be a risk factor for stroke. This study aimed to investigate whether SUA also played a role in PSF. Methods Subjects with ischemic stroke were screened from The First Affiliated Hospital of Wenzhou Medical University between January 2020 and October 2020. Patients' fatigue symptoms were assessed by the Fatigue severity scale (FSS). To investigate the relationship between SUA and PSF, binary logistic regression analysis was conducted, with the confounders being controlled. SUA levels were divided into four layers (Q1 ≤ 245 μmol/L; Q2 246–308 μmol/L; Q3 309–365 μmol/L; Q4 ≥366 μmol/L) based on the quartiles. Results SUA levels were significantly higher in the PSF group (345.96 ± 73.78 μmol/L) than the non-PSF group (295.97 ± 87.8 μmol/L, P < 0.001). There were no differences in any other variables between these two groups. After adjusting the confounders, the risk of PSF in the Q4 layer (≥366 μmol/L) was 6.05 times (95% CI 1.79–20.43, P = 0.004) higher than that in Q1 (≤245 μmol/L). Conclusion High SUA at admission was an independent risk factor for fatigue 1 year after stroke onset. High SUA (≥366 μmol/L) during stroke deserves more attention, and active control of high SUA levels may be beneficial to reduce the incidence of PSF in the chronic stage following stroke.
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Affiliation(s)
- Wenwei Ren
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Junxin Wu
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Zijing Wu
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Shuang Yang
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Xiaofang Jiang
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Minjie Xu
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Beilan Wu
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Caixia Xie
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Jincai He
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xin Yu
- School of Mental Health, Wenzhou Medical University, Wenzhou, China.,Peking University Institute of Mental Health (Sixth Hospital), Beijing, China.,National Clinical Research Center for Mental Disorders and Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China.,Beijing Municipal Key Laboratory for Translational Research on Diagnosis and Treatment of Dementia, Beijing, China
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5
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Yogev-Seligmann G, Kafri M. COVID-19 social distancing: negative effects on people with Parkinson disease and their associations with confidence for self-management. BMC Neurol 2021; 21:284. [PMID: 34284733 PMCID: PMC8289714 DOI: 10.1186/s12883-021-02313-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 06/30/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND The purpose of this study was to describe the effects of COVID-19 social distancing on the function, health, and well-being of people with Parkinson disease (PD), and test the association of these effects with patients' activation levels, i.e., their skills and confidence in managing their health. METHODS Community-dwelling individuals with PD answered an anonymous web-based survey. Part 1 included 27 multiple-choice questions regarding changes in function, health, medical care, and well-being. Part 2 consisted of the Patient Activation Measure, which enquired about skills and confidence in managing one's health. RESULTS Respondents (N = 142) reported decreases in various function (24.8%-37.3%), health (33.8%-43%), and well-being (26.1%-47.1%) domains. Rehabilitation ceased for 61.2%. Among those reporting a worsening of health, 67.8% associated this with the cessation of rehabilitative treatments or decrease in physical activity. Patients' activation levels were inversely correlated with increased assistance for activities of daily living, increased tiredness, worsening symptoms, and lack of support from family and friends. CONCLUSIONS Social distancing had a major negative impact on the health and function of people with PD. PRACTICAL IMPLICATIONS Supporting people with PD skills and confidence in managing health may preserve their physical and mental health during this period of dramatic changes in life's circumstances.
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Affiliation(s)
- Galit Yogev-Seligmann
- Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, 3498838 Haifa, Israel
| | - Michal Kafri
- Department of Physical Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
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6
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Zhang X, Fang H, Ma D, Duan Y, Wang Z, Zhang N, Wang C. Risk Factors and Imaging Mechanisms of Fatigue After Mild Ischemic Stroke: An Exploratory Study From a Single Chinese Center. Front Neurol 2021; 12:649021. [PMID: 34113307 PMCID: PMC8185271 DOI: 10.3389/fneur.2021.649021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 04/22/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: To explore the biochemical risk factors and imaging mechanisms of post fatigue after mild ischemic stroke among a Chinese population. Methods: Forty consecutive patients with mild ischemic stroke within onset of 14 ± 2 days were enrolled between March and June 2018. The clinical information, scale data, biomarkers in peripheral venous blood, and imaging data during hospitalization and follow-up period were collected. Results: Patient age (range 34-78) was positively correlated with the prevalence of fatigue (p = 0.009). Both blood norepinephrine and serotonin levels during hospitalization were negatively correlated to the prevalence of post-stroke fatigue (model 1 p = 0.009 and model 2 P = 0.043, respectively). Infarct of right cerebral hemisphere is positively correlated with the occurrence of fatigue after mild ischemic stroke (p = 0.020). Compared to non-fatigue patients, amplitude of low-frequency fluctuation (ALFF) was lower in several areas of brain in stroke patients with fatigue, including the right orbital inferior frontal, right inner orbital frontal, right frontal, right triangular frontal inferior, right anterior and lateral cingulate, and right medial frontal gyruses. Analysis of the difference in functional connectivity between the fatigue and non-fatigue groups found no cluster. Conclusions: Frontal lobe-related neural pathways may play an essential role in the regulation of fatigue after mild ischemic stroke. Abnormal neural circuits may reduce the levels of neurotransmitters such as serotonin and norepinephrine and lead to post-stroke fatigue.
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Affiliation(s)
- Xiaoxiao Zhang
- Department of Anesthesiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Hongjuan Fang
- Department of Endocrinology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Ding Ma
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yunyun Duan
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zhaozhao Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Ning Zhang
- Department of Neuropsychiatry and Behavioral Neurology and Clinical Psychology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Chunxue Wang
- Department of Neuropsychiatry and Behavioral Neurology and Clinical Psychology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Collaborative Innovation Center for Brain Disorders, Beijing Institute of Brain Disorders, Capital Medical University, Beijing, China
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Western E, Nordenmark TH, Sorteberg W, Karic T, Sorteberg A. Fatigue After Aneurysmal Subarachnoid Hemorrhage: Clinical Characteristics and Associated Factors in Patients With Good Outcome. Front Behav Neurosci 2021; 15:633616. [PMID: 34054441 PMCID: PMC8149596 DOI: 10.3389/fnbeh.2021.633616] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 04/16/2021] [Indexed: 11/18/2022] Open
Abstract
Fatigue after aneurysmal subarachnoid hemorrhage (post-aSAH fatigue) is a frequent, often long-lasting, but still poorly studied sequel. The aim of the present study was to characterize the nature of post-aSAH fatigue with an itemized analysis of the Fatigue Severity Scale (FSS) and Mental Fatigue Scale (MFS). We further wanted to assess the association of fatigue with other commonly observed problems after aSAH: mood disorders, cognitive problems, health-related quality of life (HRQoL), weight gain, and return to work (RTW). Ninety-six good outcome aSAH patients with fatigue completed questionnaires measuring fatigue, depression, anxiety, and HRQoL. All patients underwent a physical and neurological examination. Cognitive functioning was assessed with a neuropsychological test battery. We also registered prior history of fatigue and mood disorders as well as occupational status and RTW. The patients experienced fatigue as being among their three most disabling symptoms and when characterizing their fatigue they emphasized the questionnaire items “low motivation,” “mental fatigue,” and “sensitivity to stress.” Fatigue due to exercise was their least bothersome aspect of fatigue and weight gain was associated with depressive symptoms rather than the severity of fatigue. Although there was a strong association between fatigue and mood disorders, especially for depression, the overlap was incomplete. Post-aSAH fatigue related to reduced HRQoL. RTW was remarkably low with only 10.3% of patients returning to their previous workload. Fatigue was not related to cognitive functioning or neurological status. Although there was a strong association between fatigue and depression, the incomplete overlap supports the notion of these two being distinct constructs. Moreover, post-aSAH fatigue can exist without significant neurological or cognitive impairments, but is related to reduced HRQoL and contributes to the low rate of RTW.
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Affiliation(s)
- Elin Western
- Department of Neurosurgery, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway
| | - Tonje Haug Nordenmark
- Department of Physical Medicine and Rehabilitation, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway.,Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
| | - Wilhelm Sorteberg
- Department of Neurosurgery, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway
| | - Tanja Karic
- Department of Physical Medicine and Rehabilitation, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway
| | - Angelika Sorteberg
- Department of Neurosurgery, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Bragstad LK, Lerdal A, Gay CL, Kirkevold M, Lee KA, Lindberg MF, Skogestad IJ, Hjelle EG, Sveen U, Kottorp A. Psychometric properties of a short version of Lee Fatigue Scale used as a generic PROM in persons with stroke or osteoarthritis: assessment using a Rasch analysis approach. Health Qual Life Outcomes 2020; 18:168. [PMID: 32503548 PMCID: PMC7275526 DOI: 10.1186/s12955-020-01419-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 05/24/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Fatigue is a common symptom associated with a wide range of diseases and needs to be more thoroughly studied. To minimise patient burden and to enhance response rates in research studies, patient-reported outcome measures (PROM) need to be as short as possible, without sacrificing reliability and validity. It is also important to have a generic measure that can be used for comparisons across different patient populations. Thus, the aim of this secondary analysis was to evaluate the psychometric properties of the Norwegian 5-item version of the Lee Fatigue Scale (LFS) in two distinct patient populations. METHODS The sample was obtained from two different Norwegian studies and included patients 4-6 weeks after stroke (n = 322) and patients with osteoarthritis on a waiting list for total knee arthroplasty (n = 203). Fatigue severity was rated by five items from the Norwegian version of the LFS, rating each item on a numeric rating scale from 1 to 10. Rasch analysis was used to evaluate the psychometric properties of the 5-item scale across the two patient samples. RESULTS Three of the five LFS items ("tired", "fatigued" and "worn out") showed acceptable internal scale validity as they met the set criterion for goodness-of-fit after removal of two items with unacceptable goodness-of-fit to the Rasch model. The 3-item LFS explained 81.6% of the variance, demonstrated acceptable unidimensionality, could separate the fatigue responses into three distinct severity groups and had no differential functioning with regard to disease group. The 3-item version of the LFS had a higher separation index and better internal consistency reliability than the 5-item version. CONCLUSIONS A 3-item version of the LFS demonstrated acceptable psychometric properties in two distinct samples of patients, suggesting it may be useful as a brief generic measure of fatigue severity. TRIAL REGISTRATION Clinicaltrials.gov: NCT02338869; registered 10/04/2014 (stroke study).
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Affiliation(s)
- Line Kildal Bragstad
- Department of Geriatric Medicine, Oslo University Hospital, P.O Box 4956, Ullevaal, Nydalen, 0424, Oslo, Norway. .,Department of Nursing Science and Research Center for Habilitation and Rehabilitation Services and Models (CHARM), University of Oslo, Faculty of Medicine, Institute of Health and Society, P.O. Box 1130, Blindern, N-0318, Oslo, Norway.
| | - Anners Lerdal
- Department of Nursing Science, University of Oslo, Faculty of Medicine, Institute of Health and Society, P.O. Box. 1130, Blindern, N-0318, Oslo, Norway.,Department for Patient Safety and Research, Lovisenberg Diaconal Hospital, P.O. Box 04970, Nydalen, N-0440, Oslo, Norway
| | - Caryl L Gay
- Department for Patient Safety and Research, Lovisenberg Diaconal Hospital, P.O. Box 04970, Nydalen, N-0440, Oslo, Norway.,Department of Family Health Care Nursing, University of California, San Francisco, 2 Koret Way, San Francisco, CA, 94143, USA
| | - Marit Kirkevold
- Department of Nursing Science and Research Center for Habilitation and Rehabilitation Services and Models (CHARM), University of Oslo, Faculty of Medicine, Institute of Health and Society, P.O. Box 1130, Blindern, N-0318, Oslo, Norway
| | - Kathryn A Lee
- Department of Family Health Care Nursing, University of California, San Francisco, 2 Koret Way, San Francisco, CA, 94143, USA
| | - Maren Falch Lindberg
- Department of Nursing Science, University of Oslo, Faculty of Medicine, Institute of Health and Society, P.O. Box. 1130, Blindern, N-0318, Oslo, Norway.,Department for Surgery, Lovisenberg Diaconal Hospital, P.O. Box 04970, Nydalen, N-0440, Oslo, Norway
| | - Ingrid Johansen Skogestad
- Department for Medicine, Lovisenberg Diaconal Hospital, P.O. Box 04970, Nydalen, N-0440, Oslo, Norway
| | - Ellen Gabrielsen Hjelle
- Department of Nursing Science and Research Center for Habilitation and Rehabilitation Services and Models (CHARM), University of Oslo, Faculty of Medicine, Institute of Health and Society, P.O. Box 1130, Blindern, N-0318, Oslo, Norway
| | - Unni Sveen
- Department of Geriatric Medicine, Oslo University Hospital, P.O Box 4956, Ullevaal, Nydalen, 0424, Oslo, Norway.,Faculty of Health Sciences, Oslo Metropolitan University, P.O. Box 4, St. Olavs Plass, N-0130, Oslo, Norway.,Department of Physical Medicine and Rehabilitation, Oslo University Hospital, P.O. Box 4956, Nydalen, N-0424, Oslo, Norway
| | - Anders Kottorp
- Faculty of Health and Society, Malmö University, 205 06, Malmö, Sweden
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Abdulla FA, Al-Khamis FA, Alsulaiman AA, Alshami AM. Psychometric properties of an Arabic version of the fatigue severity scale in patients with stroke. Top Stroke Rehabil 2019; 26:448-455. [DOI: 10.1080/10749357.2019.1628465] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Fuad A. Abdulla
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Fahd A. Al-Khamis
- Department of Neurology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Abdulla A. Alsulaiman
- Department of Neurology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Ali M. Alshami
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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10
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Aarnes R, Stubberud J, Lerdal A. A literature review of factors associated with fatigue after stroke and a proposal for a framework for clinical utility. Neuropsychol Rehabil 2019; 30:1449-1476. [DOI: 10.1080/09602011.2019.1589530] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- Rannveig Aarnes
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Jan Stubberud
- Lovisenberg Diaconal Hospital, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Anners Lerdal
- Lovisenberg Diaconal Hospital, Oslo, Norway
- Faculty of Medicine, Department of Health and Society, Institute of Nursing Science, University of Oslo, Oslo, Norway
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11
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Abzhandadze T, Rafsten L, Lundgren-Nilsson Å, Sunnerhagen KS. Feasibility of Cognitive Functions Screened With the Montreal Cognitive Assessment in Determining ADL Dependence Early After Stroke. Front Neurol 2018; 9:705. [PMID: 30210432 PMCID: PMC6119694 DOI: 10.3389/fneur.2018.00705] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 08/03/2018] [Indexed: 11/13/2022] Open
Abstract
Objective: To investigate the feasibility of assessing cognitive function using the Montreal Cognitive Assessment (MoCA) given 36-48 h post stroke to explain dependence in activities of daily living (ADL). Methods: This is a cross-sectional, exploratory study. Cognitive function and basic ADL were assessed with the MoCA and the Barthel Index (BI), respectively, within 36-48 h of admission. Neurological functions were assessed with the National Institute of Health Stroke Scale (NIHSS) upon admittance to the hospital. Binary logistic regression analyses were performed to assess the feasibility of the MoCA in explaining ADL dependence. Results: Data were available for 550 patients (42% females, mean age 69 years). Moderate correlations (rs > +0.30, p < 0.001) were found between the total score on the BI, MoCA, and visuospatial/executive functions. The regression analysis model including only MoCA as an independent variable had a high sensitivity for explaining ADL dependence. However, the model with independent variables of MoCA, NIHSS, and age had the best area under the curve value (0.74). Conclusions: Cognitive functions assessed with the MoCA partly explain ADL dependence 36-48 h post stroke. Stroke-related neurological deficits and age should be additional considerations.
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Affiliation(s)
- Tamar Abzhandadze
- Institute of Neuroscience and Physiology, Rehabilitation medicine, University of Gothenburg, Gothenburg, Sweden.,Department of Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Lena Rafsten
- Institute of Neuroscience and Physiology, Rehabilitation medicine, University of Gothenburg, Gothenburg, Sweden.,Department of Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Åsa Lundgren-Nilsson
- Institute of Neuroscience and Physiology, Rehabilitation medicine, University of Gothenburg, Gothenburg, Sweden.,Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
| | - Katharina S Sunnerhagen
- Institute of Neuroscience and Physiology, Rehabilitation medicine, University of Gothenburg, Gothenburg, Sweden.,Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
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Bossola M, Di Stasio E, Antocicco M, Pepe G, Marzetti E, Vulpio C. 1-year course of fatigue in patients on chronic hemodialysis. Int Urol Nephrol 2017; 49:727-734. [PMID: 28054167 DOI: 10.1007/s11255-016-1496-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Accepted: 12/27/2016] [Indexed: 12/14/2022]
Abstract
PURPOSE Fatigue is common in end-stage renal disease patients receiving hemodialysis, reduces significantly their quality of life and is associated with all-cause and cardiac-related mortality. Unfortunately, little is known about the course of fatigue in patients on chronic hemodialysis. METHODS The Vitality Subscale of the SF-36 (SF-36 VS), Short-Form Health Survey, was administered to 45 patients in January (T1), June (T2) and November (T3) 2015. RESULTS The score of the SF-36 VS did not differ significantly among T1, T2 and T3. Similarly, the 1-year course of the SF-36 Vitality Subscale score did not differ significantly among T1, T2 and T3 after stratification of patients for sex, age, BMI, IADL and Charlson. Between T1 and T2, 21 out of 45 patients (46.6%) changed their fatigue status: 8 fatigued patients became not-fatigued and 13 not-fatigued patients became fatigued. Between T2 and T3, 12 out of 45 (26.6%) patients changed their fatigue status: 5 fatigued patients became not-fatigued and 7 not-fatigued patients became fatigued. Between T1 and T3, 19 out of 45 patients (42.2%) changed their fatigue status: 6 fatigued patients became not-fatigued and 13 not-fatigued became fatigued. CONCLUSION The present study is the first to identify variations in fatigue status among patients on chronic hemodialysis during 1-year course. These findings suggest to frequently assess the presence and severity of fatigue in patients on chronic hemodialysis.
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Affiliation(s)
- Maurizio Bossola
- Hemodialysis Unit, Institute of Clinical Surgery, Catholic University of the Sacred Heart, Rome, Italy.
| | - Enrico Di Stasio
- Department of Clinical Chemistry, Catholic University of the Sacred Heart, Rome, Italy
| | - Manuela Antocicco
- Department of Gerontology, Catholic University of the Sacred Heart, Rome, Italy
| | - Gilda Pepe
- Hemodialysis Unit, Institute of Clinical Surgery, Catholic University of the Sacred Heart, Rome, Italy
| | - Emanuele Marzetti
- Department of Gerontology, Catholic University of the Sacred Heart, Rome, Italy
| | - Carlo Vulpio
- Hemodialysis Unit, Institute of Clinical Surgery, Catholic University of the Sacred Heart, Rome, Italy
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Serum Phenylalanine, Tyrosine, and their Ratio in Acute Ischemic Stroke: on the Trail of a Biomarker? J Mol Neurosci 2015; 58:102-8. [PMID: 26423306 DOI: 10.1007/s12031-015-0659-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 09/21/2015] [Indexed: 01/05/2023]
Abstract
Fast diagnosis and appropriate treatment are of utmost importance to improving the outcome in patients with acute ischemic stroke (AIS). A rapid and sensitive blood test for ischemic stroke is required. The aim of this study was to examine the usefulness of phenylalanine (PHE) and tyrosine (TYR) as diagnostic biomarkers in AIS. Serum levels of PHE and TYR, measured using HPLC, and their ratio (PHE/TYR) were compared between 45 patients with AIS and 40 healthy control subjects. The relationship between PHE/TYR and the serum levels of several cytokines were also examined. PHE/TYR was significantly higher in AIS patients than in healthy controls (1.75 vs 1.24, p < 0.001). A receiver operating characteristic (ROC) curve analysis of PHE/TYR in AIS patients relative to healthy controls revealed promising sensitivity and specificity, which at an optimal cutoff of 1.45 were 76 and 85 %, respectively. PHE/TYR was positively correlated with interleukin (IL)-1β (r = 0.37, p = 0.011) and IL-6 (r = 0.33, p = 0.025). This study shows that PHE/TYR is highly elevated in the acute phase of AIS, and that this elevation is coupled to the inflammatory response. The ROC analysis documents the possible value of PHE/TYR as a biomarker for AIS and demonstrates its clinical potential as a blood-based test for AIS.
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Factors Associated with Poststroke Fatigue: A Systematic Review. Stroke Res Treat 2015; 2015:347920. [PMID: 26101691 PMCID: PMC4458555 DOI: 10.1155/2015/347920] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Revised: 04/20/2015] [Accepted: 05/12/2015] [Indexed: 11/17/2022] Open
Abstract
Background. Poststroke fatigue (PSF) is a frequent, disabling symptom that lacks a consensual definition and a standardized evaluation method. The (multiple) causes of PSF have not been formally characterized. Objective. To identify factors associated with PSF. Method. A systematic review of articles referenced in MEDLINE. Only original studies having measured PSF and potentially associated factors were included. Data was extracted from articles using predefined data fields. Results. Although PSF tends to be more frequent in female patients and older patients, sociodemographic factors do not appear to have a major impact. There are strong associations between PSF and emotional disturbances (such as depression and anxiety). PSF may also be linked to attentional disturbances (mainly slowing in processing speed). The literature data have failed to demonstrate a clear impact of the type and severity of stroke. It has been suggested that PSF results from alterations in the frontothalamostriatal system and/or inflammatory processes. Pain, sleep disorders, and prestroke fatigue also appeared to be associated with PSF. Implications. A better understanding of PSF may improve stroke patient care and facilitate the development of effective treatments.
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Sehle A, Vieten M, Mündermann A, Dettmers C. Difference in Motor Fatigue between Patients with Stroke and Patients with Multiple Sclerosis: A Pilot Study. Front Neurol 2014; 5:279. [PMID: 25566183 PMCID: PMC4273629 DOI: 10.3389/fneur.2014.00279] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Accepted: 12/08/2014] [Indexed: 11/13/2022] Open
Abstract
Fatigue is often reported in stroke patients. However, it is still unclear if fatigue in stroke patients is more prominent, more frequent or more "typical" than in patients with multiple sclerosis (MS) and if the pathophysiology differs between these two populations. The purpose of this study was to compare motor fatigue and fatigue-induced changes in kinematic gait parameters between stroke patients, MS patients, and healthy persons. Gait parameters at the beginning and end of a treadmill walking test were assessed in 10 stroke patients, 40 MS patients, and 20 healthy subjects. The recently developed Fatigue index Kliniken Schmieder (FKS) based on change of the movement's attractor and its variability was used to measure motor fatigue. Six stroke patients had a pathological FKS. The FKS (indicating the level of motor fatigue) in stroke patients was similar compared to MS patients. Stroke patients had smaller step length, step height and greater step width, circumduction with the right and left leg, and greater sway compared to the other groups at the beginning and at the end of test. A severe walking impairment in stroke patients does not necessarily cause a pathological FKS indicating motor fatigue. Moreover, the FKS can be used as a measure of motor fatigue in stroke and MS and may also be applicable to other diseases.
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Affiliation(s)
- Aida Sehle
- Division of Sport Science, University of Konstanz , Konstanz , Germany ; Lurija Institute, Kliniken Schmieder Allensbach , Allensbach , Germany
| | - Manfred Vieten
- Division of Sport Science, University of Konstanz , Konstanz , Germany
| | - Annegret Mündermann
- Division of Sport Science, University of Konstanz , Konstanz , Germany ; Department of Orthopaedics, University Hospital Basel , Basel , Switzerland
| | - Christian Dettmers
- Lurija Institute, Kliniken Schmieder Allensbach , Allensbach , Germany ; Kliniken Schmieder Konstanz , Konstanz , Germany
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Tang WK, Chen YK, Liang HJ, Chu WCW, Mok VCT, Ungvari GS, Wong KS. Subcortical white matter infarcts predict 1-year outcome of fatigue in stroke. BMC Neurol 2014; 14:234. [PMID: 25496671 PMCID: PMC4272810 DOI: 10.1186/s12883-014-0234-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Accepted: 12/01/2014] [Indexed: 12/12/2022] Open
Abstract
Background Fatigue is common in stroke survivors. Lesion location may influence the risk of poststroke fatigue (PSF) but it is uncertain whether location has an impact on the prognosis of PSF. This study examined the association between PSF outcome and infarct location. Methods The study sample comprised 435 Chinese patients with acute ischemic stroke admitted to the acute stroke unit of a university affiliated regional hospital in Hong Kong. Three and fifteen months after the onset of the index stroke a research assistant administered the Fatigue Severity Scale (FSS). PSF was defined as a FSS score of 4.0 or above. Of the 139 patients with PSF three months poststroke, 97 (69.8%) attended the 15-month follow-up, when 50 (51.5%) patients still had PSF (‘non-remitters’) and 47 (48.5%) did not report fatigue (‘remitters’). The presence and location of infarcts were evaluated with magnetic resonance imaging. Results In comparison with the remitters, the non-remitters were more likely to have subcortical white matter infarcts (40.0% vs 21.3%, p = 0.046). These infarcts remained an independent predictor of non-remission of PSF in the multivariate analysis, with an odds ratio of 4.208 (p = 0.011). Conclusions The results suggest that subcortical white matter infarcts may influence the outcome of PSF. Further investigations are needed to explore whether infarcts have any impact on the response of PSF to pharmacological or psychological interventions.
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Affiliation(s)
- Wai Kwong Tang
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, SAR, China. .,Department of Psychiatry, Shatin Hospital, Shatin, NT, Hong Kong, SAR, China.
| | - Yang Kun Chen
- Department of Neurology, Dongguan People's Hospital, Dongguan, Guangdong, PR China.
| | - Hua Jun Liang
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, SAR, China.
| | - Winnie Chiu Wing Chu
- Department of Imaging and Interventional Radiology, Chinese University of Hong Kong, Hong Kong, SAR, China.
| | - Vincent Chung Tony Mok
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, SAR, China.
| | - Gabor S Ungvari
- The University of Notre Dame Australia/Marian Centre, Perth, Australia. .,School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Australia.
| | - Ka Sing Wong
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, SAR, China.
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Wang SS, Wang JJ, Wang PX, Chen R. Determinants of fatigue after first-ever ischemic stroke during acute phase. PLoS One 2014; 9:e110037. [PMID: 25302807 PMCID: PMC4193856 DOI: 10.1371/journal.pone.0110037] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 09/14/2014] [Indexed: 11/24/2022] Open
Abstract
Background and Purpose Fatigue after stroke is common and has a negative impact on rehabilitation and survival. However, its pathogenesis and contributing factors remain unclear. The purpose of this study was to identify factors influencing the occurrence of fatigue after first-ever ischemic stroke in acute phase. Methods We examined 265 consecutive patients with first-ever ischemic stroke during acute phase (within 2 weeks) in two tertiary stroke care hospitals in Henan, China. We documented patients’ demographic and clinical characteristics through face-to-face interviews using structured questionnaires and reviews of medical records. Post-stroke fatigue was defined as a score of ≥4 using the Fatigue Severity Scale. Multivariate logistic regression was used to examine post-stroke fatigue in relation to socio-demographic, lifestyle, clinical characteristics and family function. Results About 40% first-ever ischemic stroke patients experienced post-stroke fatigue in acute phase. Post-stroke fatigue was associated with lack of exercise before stroke (adjusted odds ratio 4.01, 95% CI 1.95–8.24), family dysfunction (2.63, 1.20–5.80), depression (2.39, 1.02–5.58), the presence of pre-stroke fatigue (4.89, 2.13–11.21), use of sedative medications (4.14, 1.58–10.88), coronary heart disease (3.38, 1.46–7.79) and more severe Modified Rankin Scale (2.55, 1.65–3.95). Conclusions The causes of post-stroke fatigue are multifaceted. More physical exercise, improving family function, reducing depression and appropriate use of sedative medications may be helpful in preventing post-stroke fatigue.
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Affiliation(s)
- Shan-Shan Wang
- Institute of Public Health, School of Nursing, Henan University, Kaifeng, China
| | - Jia-Ji Wang
- Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Pei-Xi Wang
- Institute of Public Health, School of Nursing, Henan University, Kaifeng, China
- Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, China
- * E-mail: (PXW); (RC)
| | - Ruoling Chen
- Department of Primary Care and Public Health Sciences, King’s College London, London, United Kingdom
- Centre for Health and Social Care Improvement (CHSCI), University of Wolverhampton, Wolverhampton, United Kingdom
- * E-mail: (PXW); (RC)
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Vincent-Onabajo G, Adamu A. Impact of poststroke fatigue on health-related quality of life of nigerian stroke survivors. J Stroke 2014; 16:195-201. [PMID: 25328879 PMCID: PMC4200597 DOI: 10.5853/jos.2014.16.3.195] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Revised: 08/31/2014] [Accepted: 09/07/2014] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND AND PURPOSE A stroke event is often characterized by a number of debilitating consequences that may impact negatively on the health-related quality of life (HRQL) of survivors. This study examined the impact of poststroke fatigue (PSF), a persistent and prevalent stroke consequence, on HRQL of Nigerian stroke survivors. METHODS One hundred stroke survivors were recruited from the physiotherapy outpatient departments of two tertiary hospitals in Northern Nigeria. The Fatigue Severity Scale and Health-Related Quality of Life in Stroke Patients-26 were respectively used to assess PSF and HRQL. The independent impact of PSF on overall and domain-specific HRQL was examined using hierarchical regression analyses. RESULTS Mean age of the stroke survivors was 55.32 years (SD 13.9 years). The majority were males (66%), had suffered ischemic stroke (70%) and presented with moderately severe disability (42%). After controlling for demographic and stroke-related variables, PSF was found to be significantly and independently associated with all the domains of HRQL albeit at varying degrees. While the influence of PSF on the emotional domain was the most pronounced and uniquely contributed to 15% of the variance in the domain, its influence on the cognitive domain was the least prominent. PSF also solely accounted for 9% of the variation in overall HRQL with higher levels of PSF related with lower HRQL. CONCLUSIONS Being a potentially treatable condition, PSF's significant impact on HRQL has implications for successful stroke care and rehabilitation. For instance, addressing PSF through appropriate interventions may assist in enhancing HRQL of stroke survivors.
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Affiliation(s)
- Grace Vincent-Onabajo
- Department of Medical Rehabilitation (Physiotherapy), College of Medical Sciences, University of Maiduguri, Nigeria
| | - Abdulbaqi Adamu
- Department of Medical Rehabilitation (Physiotherapy), College of Medical Sciences, University of Maiduguri, Nigeria
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Wu D, Wang L, Teng W, Huang K, Shang X. Correlation of fatigue during the acute stage of stroke with serum uric acid and glucose levels, depression, and disability. Eur Neurol 2014; 72:223-7. [PMID: 25247752 DOI: 10.1159/000364902] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Accepted: 05/27/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND To clarify the correlation of fatigue during the acute stage of stroke with serum uric acid (UA) and glucose levels, depression, and disability. DESIGN Cross-sectional descriptive study. METHODS A stroke group of 312 patients and a reference group of 312 healthy controls were recruited during the same period. Fatigue was assessed using the Fatigue Severity Scale (FSS). Patients with an FSS score ≥4 points were defined as having fatigue. Depression was assessed using the Self-rating Depression Scale (SDS). Patients with an SDS score ≥50 points were defined as having depression. Stroke severity and the level of disability were assessed with the National Institutes of Health Stroke Scale (NIHSS) and the Modified Rankin Scale (MRS). RESULTS The prevalence of fatigue in the stroke group was higher than that in the reference group (p < 0.001). Within the stroke group, low serum UA level, high MRS score, high serum glucose level, and high SDS score were associated with increased FSS score. The MRS score was associated most consistently with the FSS score (B = 0.411, 95% CI: 0.297, 0.525). Age, gender, chronic disease history, and NIHSS score were not associated with FSS score. CONCLUSIONS Serum UA and glucose levels, depression, and disability are closely related to fatigue during the acute stage of ischaemic stroke.
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Affiliation(s)
- Dan Wu
- Department of Neurology, The First Affiliated Hospital, China Medical University, Shenyang, China
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Lee KA, Dziadkowiec O, Meek P. A systems science approach to fatigue management in research and health care. Nurs Outlook 2014; 62:313-21. [DOI: 10.1016/j.outlook.2014.07.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Revised: 07/02/2014] [Accepted: 07/03/2014] [Indexed: 10/25/2022]
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Activation of the Kynurenine Pathway in the Acute Phase of Stroke and its Role in Fatigue and Depression Following Stroke. J Mol Neurosci 2014; 54:181-7. [DOI: 10.1007/s12031-014-0272-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2014] [Accepted: 02/24/2014] [Indexed: 12/21/2022]
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Lerdal A, Gay CL. Fatigue in the acute phase after first stroke predicts poorer physical health 18 months later. Neurology 2013; 81:1581-7. [PMID: 24078734 PMCID: PMC3806915 DOI: 10.1212/wnl.0b013e3182a9f471] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objective: To determine whether fatigue in the acute phase following stroke predicts long-term patient-reported physical and mental health outcomes 18 months later. Methods: Patients (n = 96, mean age 67.8 years, SD 12.9) were assessed within 2 weeks of hospital admission for first-ever stroke (acute phase) and 18 months later. Measures included the Fatigue Severity Scale and the Beck Depression Inventory II. The Short Form–36 was used to assess self-reported physical and mental health. Multivariate regression analysis was used to evaluate the relationship between acute phase fatigue and later health outcomes, controlling for relevant covariates. Results: Acute phase fatigue was associated with physical health at 18-month follow-up, but not with mental health. After adjusting for other potential predictors of health outcomes, including age, sex, cohabitation status, acute phase physical or mental health, and depressive symptoms, acute phase fatigue remained a significant predictor of later physical health but not of later mental health. The reverse relationships were also examined, but neither physical nor mental health in the acute phase predicted fatigue at 18 months; the best predictor of fatigue at 18-month follow-up was acute phase fatigue. Conclusions: These findings suggest that acute phase fatigue is an independent risk factor for poor physical health 18 months after stroke. Diagnosis and treatment of acute phase fatigue may improve physical health-related quality of life among stroke survivors. Effective treatments for poststroke fatigue, both in the acute phase and later in the recovery period, are needed.
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Affiliation(s)
- Anners Lerdal
- From the Department of Research (A.L., C.L.G), Lovisenberg Diakonale Hospital, Oslo; the Department of Nursing Science (A.L.), Institute of Health and Society, Faculty of Medicine, University of Oslo, Norway; the Department of Family Health Care Nursing (C.L.G.), University of California, San Francisco; and Lovisenberg Diakonale University College (C.L.G.), Oslo, Norway
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Ormstad H, Verkerk R, Aass HCD, Amthor KF, Sandvik L. Inflammation-induced catabolism of tryptophan and tyrosine in acute ischemic stroke. J Mol Neurosci 2013; 51:893-902. [PMID: 23990339 DOI: 10.1007/s12031-013-0097-2] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Accepted: 08/12/2013] [Indexed: 01/04/2023]
Abstract
Whether the inflammatory response that accompanies acute ischemic stroke induces the kynurenine pathway is currently a matter of conjecture. Activation of this pathway may disturb active metabolites. The aim of this study was thus to characterize the catabolism of tryptophan and tyrosine in acute ischemic stroke (AIS) patients, and its association with cytokines, C-reactive protein, and glucose. Serum levels of 5-hydroxytryptamine, tryptophan catabolites, and competing amino acids and significant ratios of these were measured in 45 AIS patients and compared to those of 40 control subjects. Furthermore, associations between the serum levels of these biomarkers and serum levels of cytokines, C-reactive protein, and glucose were determined. Significantly lower levels of tryptophan and tyrosine in the stroke group indicate increased tryptophan and tyrosine oxidation in acute ischemic stroke, while significantly lowered tryptophan index and tyrosine index indicate a reduced capacity for the synthesis of 5-hydroxytryptamine and catecholamines in the brain, respectively. Furthermore, our findings indicate that the proinflammatory response in acute ischemic stroke may be responsible for a reduced capacity for the biosynthesis of brain catecholamines and mediate neurotoxic effects. Meanwhile, the anti-inflammatory IL-10 may exert a neuroprotective effect and prevent the putative reduced capacity for 5-hydroxytryptamine synthesis in the brain. These mechanisms may be involved in several sequelae following stroke, such as cognitive impairment, depression, and fatigue.
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Affiliation(s)
- Heidi Ormstad
- Department of Health Sciences, Buskerud University College, Drammen, Norway,
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