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Post-stroke fatigue is one of the common symptoms of stroke patients. Continuous fatigue will affect the rehabilitation of patients' limb functions, lead to the decline of daily living ability, and at the same time, make patients lack energy, lose the initiative of rehabilitation exercise, and seriously affect the quality of life and social function. This article reviews the epidemiology, clinical characteristics, evaluation scales, influencing factors, pathophysiological mechanism and treatment of post-stroke fatigue.
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Physical fatigue often appears after stroke, which may influence rehabilitation training and recovery. This paper introduced the causes, clinical manifestations and related factors of physical fatigue after stroke. Energy metabolism increases after stroke, which may play a role in physical fatigue after stroke, and can be managed in some ways. It is needed to research the application of energy metabolism measure in physical fatigue after stroke further.
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Objective@#To investigate the effects of acute fatigue on the outcome of aged patients with cerebral infarction.@*Methods@#The Fatigue Severity Scale was used to investigate the incidence of fatigue in 240 elderly patients with acute cerebral infarction, to assess the outcome of the patients at discharge and one year after discharge, and to analyze the effect of acute fatigue on the functional recovery and survival of patients.@*Results@#Totally 89 patients (37.1%) suffered from acute fatigue.Multivariate Logistic regression analysis showed that high admission NIHSS score(OR=2.472, 95%CI= 1.931-3.164)and acute post-stroke fatigue(OR=4.820, 95%CI=2.281~10.187)were the influencing factors for functional recovery of elderly patients with cerebral infarction at discharge(P<0.01). High admission NIHSS score(OR=1.674, 95%CI=1.411-1.985), acute post-stroke fatigue(OR=2.123, 95%CI=1.187-3.796), mRS score≥ 2 at discharge(OR=9.822, 95%CI=4.899-19.693)and recurrence(OR=6.146, 95%CI=2.596-14.553)were independent risk factors for functional recovery of elderly patients with cerebral infarction one year after discharge (P<0.05). Multivariate Cox regression analysis showed that age (OR=1.096, 95%CI=1.027-1.169), post-stroke fatigue in acute phase OR=5.233, 95%CI=1.051-6.053)and recurrence(OR=13.983, 95%CI=2.821-49.307)were independent predictors of mortality for elderly patients with cerebral infarction (P<0.05).@*Conclusion@#Fatigue after acute stroke can effect the functional recovery and survival of elderly patients with cerebral infarction.
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Objective To investigate the effects of acute fatigue on the outcome of aged patients with cerebral infarction. Methods The Fatigue Severity Scale was used to investigate the incidence of fa-tigue in 240 elderly patients with acute cerebral infarction,to assess the outcome of the patients at discharge and one year after discharge,and to analyze the effect of acute fatigue on the functional recovery and survival of patients. Results Totally 89 patients (37. 1%) suffered from acute fatigue. Multivariate Logistic regres-sion analysis showed that high admission NIHSS score(OR=2. 472,95%CI= 1. 931-3. 164) and acute post-stroke fatigue(OR=4. 820,95%CI=2. 281~10. 187) were the influencing factors for functional recovery of elderly patients with cerebral infarction at discharge(P<0. 01). High admission NIHSS score( OR=1. 674, 95%CI=1. 411-1. 985),acute post-stroke fatigue( OR=2. 123,95%CI=1. 187-3. 796),mRS score≥ 2 at discharge(OR=9. 822,95%CI=4. 899-19. 693) and recurrence( OR=6. 146,95%CI=2. 596-14. 553) were independent risk factors for functional recovery of elderly patients with cerebral infarction one year after dis-charge ( P<0. 05). Multivariate Cox regression analysis showed that age (OR=1. 096,95% CI=1. 027-1. 169),post-stroke fatigue in acute phase OR=5. 233, 95% CI=1. 051-6. 053) and recurrence ( OR=13. 983,95%CI=2. 821-49. 307) were independent predictors of mortality for elderly patients with cerebral infarction (P<0. 05). Conclusion Fatigue after acute stroke can effect the functional recovery and survival of elderly patients with cerebral infarction.
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Objective To observe the effects of transcranial magnetic stimulation combined with exercise training on fatigue and interleukin-1β (IL-1β),interleukin-9,interleukin-10,tumor necrosis factor-α and C-reactive protein (CRP) in patients with post-stroke fatigue (PSF).Methods A total of 90 patients with post-stroke fatigue were recruited and randomly divided into an observation group and a control group.Both groups were given routine exercise training,and the observation group was treated with transcranial magnetic stimulation in addition.Simplified Fugl-Meyer Motor Function Scale (FMA) and Fatigue Severity Scale (FSS) were used to assess the motor function of the limbs and fatigue of the two groups before treatment,4 and 8 weeks after treatment.At the same time,the levels of IL-1 β,IL-9,IL-10,TNF-α and CRP in the serum of the two groups were measured at the above time points.The correlation among the motor function,fatigue and cytokine levels was analyzed.Results There was no significant difference in the levels of IL-1β,IL-9,IL-10,TNF-α and CRP between the two groups before treatment (all P＞0.05);FMA score and fatigue improvement in the observation group were significantly better than those in the control group after treatment for 4 and 8 weeks (all P＜0.05);and serum levels of IL-1β,IL-9,IL-10,TNF-α and CRP in the observation group were significantly lower than those in the control group after treatment (all P＜0.05).Pearson correlation analysis showed that FMA scores of limbs were negatively correlated with serum levels of IL-1β,IL-9,IL-10,TNF-α and CRP (P＜0.05),and FSS scores were positively correlated with serum levels of IL-1β,IL-9,IL-10,TNF-α and CRP (P＜0.05).Conclusion Transcranial magnetic stimulation combined with exercise therapy can significantly improve the motor function and ameliorate fatigue of PSF patients.The therapeutic mechanism may be related to the reduction of serum levels of IL-1β,IL-9,IL-10,TNF-α and CRP.
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Objective To explore the correlation between limb heaviness and muscle strength, post-stroke fatigue (PSF) in stroke patients. Methods A total of 110 stroke patients were selected. The general information scale, Modified Rankin Scale (MRS), Modified Barthel Scale, Fatigue Severity Scale (FSS) were used to assess limb heaviness and muscle strength, PSF, and functional status. And to research the relationship of limb heaviness and muscle strength, PSF in stroke patients. Results The incidence of limb heaviness in stroke patients was 40.91％(45/110). FSS and Modified Barthel Score showed significant difference in whether patients have limb heaviness (t=-3.244, P=0.002; t=2.019, P=0.046). Spearman correlation analysis results showed that the FSS score was positively related with limbs heaviness ( r=0.384, P=0.000), but muscle strength, Modified Barthel Score, Modified Rankin Score had no correlation with limbs heaviness (r=0.091, P=0.346;r=0.185, P=0.053;r=0.132, P=0.132). Conclusion A higher incidence of stroke patients with limb heaviness. The change of muscle strength won′t promote limbs heaviness, but patients with PSF were easier to concurrent limbs heaviness, also affect the ability of the patients life, should be highly valued by medical workers, and have to intervention.
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Objective To investigate the effect of diaphragm training on respiratory function and the activities of daily living after cerebral apoplexy.Methods Seventy-eight patients with post-stroke fatigue were randomly divided into a treatment group and a routine therapy group,each of 39.Both groups were given conventional rehabilitation treatment,while the treatment group was additionally provided with diaphragm muscle training.Before and after 4 weeks of treatment,both groups were evaluated using pulmonary function tests,a fatigue severity scale (FSS),Fugl-Meyer motor function assessment (FMA) and the modified Barthel index (MBI).Results Vital capacity,forced vital capacity,forced vital capacity during the first second,and especially the maximum ventilatory volume of the treatment group were all significantly improved after the treatment.There was also significant improvement in that group's average FSS score,but not in that of the control group.The average FMA and MBI scores for both groups had improved significantly after the intervention,with the average FMA score of the treatment group significantly higher than that of the control group.However,no significant differences in the average MBI score were observed after the treatment.Conclusion Diaphragm training can significantly improve motor function and the daily life of stroke survivors.The mechanism may be related to improved respiratory function and decreased severity of fatigue.
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Objective To observe the effectiveness of Dabugantang decoction on post-stroke fatigue. Methods 83 stroke patients were included and divided into control group (n=45) and treatment group (n=38). Both groups accepted routine rehabilitation, while the treatment group was administrated with Dabugantang decoction twice daily for 4 weeks in addition. All the patients were evaluated with Fatigue Sever-ity Scale (FSS), Hamilton Depression Scale (HAMD), and Modified Barthel Index (MBI) before and after treatment. Results The scores of HAMD and MBI increased significantly in both groups after treatment (P0.05). There were statistical differences in the scores of FSS, HAMD and MBI between two groups after treatment (P<0.05). Conclusion Dabugantang decoction can alleviate the fa-tigue and depression in stroke patients and improve activities of daily living.
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@# Objective To observe the effectiveness of Dabugantang decoction on post-stroke fatigue. Methods 83 stroke patients were included and divided into control group (n=45) and treatment group (n=38). Both groups accepted routine rehabilitation, while the treatment group was administrated with Dabugantang decoction twice daily for 4 weeks in addition. All the patients were evaluated with Fatigue Severity Scale (FSS), Hamilton Depression Scale (HAMD), and Modified Barthel Index (MBI) before and after treatment. Results The scores of HAMD and MBI increased significantly in both groups after treatment (P<0.05). The score of FSS significantly decreased in the treatment group after treatment (P<0.05), but no significant difference was found in the control group (P>0.05). There were statistical differences in the scores of FSS, HAMD and MBI between two groups after treatment (P<0.05). Conclusion Dabugantang decoction can alleviate the fatigue and depression in stroke patients and improve activities of daily living.
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@#ObjectiveTo observe the effect of Buzhongyiqi decoction on post stroke fatigue.Methods60 stroke patients with fatigue were given Buzhongyiqi decoction for 4 weeks continuously. Chinese New Drug Clinical Guidelines was to evaluate the effect for patients according to improvement of symptoms.ResultsIn 60 cases, markedly effective in 47 cases (78.33%), effective in 10 patients (16.67%), invalid in 3 cases (5%). Symptoms of malaise, anorexia, muscle soreness were significantly improved.ConclusionBuzhongyiqi decoction can improve post stroke fatigue of stroke patients.
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Objective To study the clinical effect of qi supplementation combined with rehabilitation on the severity of fatigue after ischcmic stroke in patients with qi deficiency. Methods Ninety ischemic stroke patients with qi deficiency were randomly divided into 3 groups of 30. The treatment group was treated with an oral decoction of qi-supplementing Chinese medicine and also rehabilitation. The Western medicine control group was treated with a Chinese medicine placebo, Western medicine and rehabilitation. The blank control group was treated with the Chinese medicine placebo and rehabilitation. All groups were evaluated using a stroke-specific quality of life scale ( SSQOL) and a fatigue severity scale (FSS) before and 4 weeks after treatment. Results After treatment, the average SS-QOL and FSS scores had improved significantly compared with those before treatment, especially in the two treatment groups. There was a significant difference between the treatment group and the Western medicine control group,and between the treatment group and the blank control group on both scales. There was also a significant difference between the Western medicine control group and the blank control group in terms of SS-QOL scores, but not FSSscores. Conclusion All 3 treatments alleviated fatigue in ischemic stroke patients with a qi deficiency. Qi supplementation combined with rehabilitation was the most effective, followed by Western medicine combined with rehabilitation.