Post-stroke fatigue and its dimensions over the second half year after stroke.

OBJECTIVE: Introduction: Post-stroke fatigue (PSF) is a common and often debilitating sequel of both ischemic and hemorrhagic strokes. The aim: Assess the rates and intensities of PSF over the second half year after stroke. PATIENTS AND METHODS: Materials and methods: There were examined 128 patients at 6, 9 and 12 months after ischemic or hemorrhagic stroke onset. PSF was measured by fatigue assessment scale (FAS), multidimensional fatigue inventory-20 (MFI-20) and fatigue severity scale (FSS). Distributions of continuous variables were checked by Shapiro-Wilk test. Parametric variables were represented as mean±standard deviation, non-parametric - as mediana (Me) and interquartile (25%-75%) range (Q1-Q3). Categorical data were represented by number (n) and percentage. The difference between the patients' proportions with PSF at definite time points after stroke onset was assessed using Cochran's Q-test. The Friedman F-test for repeated measurements was performed to analyze multiple non-parametric variables. When the Friedman F-test yielded a significant effect (p<0,05), it was followed by Dunnett's test for determination the differences between initial and subsequent measurements. A p-value <0,05 was considered statistically significant. RESULTS: Results: According to FAS and MFI-20 "global fatigue" sub-scale, PSF rates over the second half year after stroke were statistically stable and were present, respectively, in 28,1% and 34,0% at 6 months, in 26,2% and 32,4% at 9 months, in and 32,0% and 30,5% cases at 12 months after stroke. Physical, mental, activity-related and motivational PSF domains, due to MFI-20 sub-scales, had roughly similar percentage without any significant dynamics over the studied period. According to FSS value ranks, proportions of patients with different levels of PSF impact on daily life were statistically stable over the studied post-stroke period. However, it has been revealed significant reduction of PSF intensities in physical and activity-related domains whereas severities of mental and motivational PSF aspects have been statistically increased. CONCLUSION: Conclusions: Rates of PSF were stable over the second half year after stroke occurrence, however intensities of mental and motivational PSF domains have been statistically increased, whereas severities of physical and activity-related PSF domains have been significantly decreased.

Clinical factors related to post-stroke fatigue within the first 3 month after acute cerebrovascular events.

INTRODUCTION: Post-stroke fatigue (PSF) is a common stroke complication with long-term negative consequences. AIM: Assess the rates of certain PSF domains within first 3 months after different acute cerebrovascular events (ACE) and identify clinical factors associated with each PSF domain. MATERIAL AND METHODS: There were examined 285 patients (195 with ischemic strokes, 39 with hemorrhagic strokes and 51 with transient ischemic attacks (TIA)) consequently at hospital stay, in 1 month and in 3 months after ACE. Global PSF and certain PSF domains were measured by multidimensional fatigue inventory-20 scale. RESULTS: In 1 month and in 3 months after stroke, in comparison with TIA, it has been identified the significant prevalence of only such PSF aspects that are just related to physical activity (physical PSF and activity-related PSF). In multivariate logistic regression analysis the majority of clinical variables as for ischemic strokes (subtype, affected cerebral arterial region, affected cerebral hemisphere, recurrent stroke, post-stroke urinary tract infection, pyrexia, stroke severity according to NIHSS score) and for hemorrhagic strokes (affected cerebral hemisphere, stroke severity according to NIHSS score) were not significantly associated with any PSF domain at any time point after each ACE. On the other hand, in stroke patients it had been found reliable associations between risk of global PSF, activity-related PSF during hospital stay and presence of post-stroke pneumonia, between risk of global PSF, mental PSF in 1 months after stroke and MRS score, between risk of physical PSF in 3 months after stroke and MRS score. CONCLUSION: Active prevention of post-stroke pneumonia and early post-stroke rehabilitation probably may be helpful for PSF prevention within first 3 months after stroke.

Post-stroke fatigue and its dimensions within first 3 months after stroke.

INTRODUCTION: Post-stroke fatigue (PSF) is a common stroke complication with long-term negative consequences. AIM: Assess the qualitative and quantitative PSF characteristics during 3 month post-stroke period. MATERIALS AND METHODS: There were examined 141 patients with acute ischemic or hemorrhagic strokes at hospital stay, in 1, 2 and 3 months after stroke. PSF was measured by fatigue assessment scale (FAS), multidimensional fatigue inventory-20 (MFI-20) and fatigue severity scale (FSS). RESULTS: 116 (82.3%) patients had ischemic strokes, 25 (17.7%) had hemorrhagic strokes. According to FAS and MFI-20 "global fatigue" sub-scale, PSF was present, respectively, in 22.0% and 25.5% cases at hospital stay, in 38.3% and 35.5% cases in 3 month after stroke. The growing prevalence of PSF was based on significantly increasing the rates of PSD physical domain (from 28.4% to 41.1%) and the rates of PSF mental domain (from 19.1% to 31.9%). On the other hand, the rates of PSF activity-related component had been significantly reduced from 36.2% to 17.0% within observation period. Moreover, according to MFI-20, it had been revealed significant increasing of PSF intensities in global, physical and mental domains during first 3 post-stroke months. According to FSS value ranks, proportions of patients with "no PSF" had been decreased in 1.5 times due to simultaneously rising rates of "moderate" as well as "severe" PSF impacts on daily life. CONCLUSION: The PSF spreading is significantly increased during the first 3 post-stroke months due to increasing of rates and intensities of physical and mental PSF domains.