Interventions for post-stroke fatigue

Wu, Simiao; Kutlubaev, Mansur A.; Chun, Hoâ€Yan Y; Cowey, Eileen; Pollock, Alex; Macleod, Malcolm; Dennis, Martin; Keane, E; Sharpe, Michael; Mead, Gillian

doi:10.1002/14651858.cd007030.pub3

Cited by 123 publications

(117 citation statements)

References 43 publications

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“…However, the generalizability of the study is limited because it included only female patients with subarachnoid hemorrhage and the method of allocation concealment was doubtful. 121,122 Modafinil, a drug originally used for patients with hypersomnia or narcolepsy to promote wakefulness, relieved PSF in patients with brainstem-diencephalic strokes better than in patients cortical stroke. 123 The differential effect of modafinil in brainstem stroke may have been attributable to the fact that fatigue in these patients resulted from a dysfunctional reticular activating system.…”

Section: Pharmacological Interventionmentioning

confidence: 99%

“…128 Antioxidant idebenone, a synthetic coenzyme Q10 analog, was reported to be effective in managing PSF. 122,129 None of these trials were powered adequately, nor were any of them randomized controlled trials.…”

Section: Pharmacological Interventionmentioning

confidence: 99%

“…Trials included 2 nonpharmacological interventions, a fatigue education program, and a mindfulness-based stress reduction program. 122 There was insufficient evidence on the efficacy of any intervention to treat or prevent PSF. It was noted that trials have been small and heterogeneous, and some have had a high risk of bias.…”

Section: Interventionsmentioning

confidence: 99%

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Poststroke Fatigue: Emerging Evidence and Approaches to Management: A Scientific Statement for Healthcare Professionals From the American Heart Association

Hinkle¹,

Becker²,

Kim³

et al. 2017

Stroke

142

129

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At least half of all stroke survivors experience fatigue; thus, it is a common cause of concern for patients, caregivers, and clinicians after stroke. This scientific statement provides an international perspective on the emerging evidence surrounding the incidence, prevalence, quality of life, and complex pathogenesis of poststroke fatigue. Evidence for pharmacological and nonpharmacological interventions for management are reviewed, as well as the effects of poststroke fatigue on both stroke survivors and caregivers.

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Section: Pharmacological Interventionmentioning

confidence: 99%

Section: Pharmacological Interventionmentioning

confidence: 99%

See 1 more Smart Citation

Poststroke Fatigue: Emerging Evidence and Approaches to Management: A Scientific Statement for Healthcare Professionals From the American Heart Association

Hinkle¹,

Becker²,

Kim³

et al. 2017

Stroke

142

129

View full text Add to dashboard Cite

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“…Both groups showed significantly improved fatigue scores compared with a 3-month baseline period, with the combined intervention superior to cognitive therapy alone 42. However, a recent Cochrane review concluded that there was insufficient evidence on the efficacy of any intervention to treat or prevent poststroke fatigue 43. We conclude that patients after stroke should be screened, assessed and treated as appropriate for obstructive sleep apnoea.…”

Section: Factors Associated With Pa and Exercise After Strokementioning

confidence: 84%

Exercise for stroke prevention

Prior

Suskin

2018

Stroke Vasc Neurol

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We review evidence concerning exercise for stroke prevention. Plausible biological reasons suggest that exercise would be important in preventing stroke. While definitive randomised controlled trials evaluating the impact of physical activity (PA) and exercise on preventing stroke and mortality are lacking, observational studies, small randomised controlled trials and meta-analyses have provided evidence that PA and exercise favourably modify stroke risk factors, including hypertension, dyslipidaemia, diabetes, sedentary lifestyle, obesity, excessive alcohol consumption and tobacco use. It is, therefore, important to understand the factors associated with poststroke PA/exercise and cardiorespiratory fitness. Positively associated factors include self-efficacy, social support and quality of patients’ relationships with health professionals. Negatively associated factors include logistical barriers, medical comorbidities, stroke-related deficits, negative exercise beliefs, fear of falling, poststroke fatigue, arthropathy/pain and depression. Definitive research is needed to specify efficacious behavioural approaches to increase poststroke exercise. Effective techniques probably include physician endorsement of exercise programmesto patients, enhancement of patient–professional relationships, providing patients an exercise rationale, motivational interviewing, collaborative goal-setting with patients, addressing logistical concerns, social support in programsmes, structured exercise programming, individualised behavioural instruction, behavioural diary recording, reviewing behavioural consequences of exercise efforts, reinforcing successful exercise performance. Exercise programming without counselling may increase short-term activity; simple advice or information-giving is probably ineffective. Older patients or those with cognitive impairment may need increased structure, with emphasis on behaviour per se, versus self-regulation skills. We support the latest American Heart Association/American Stroke Association guidelines (2014) recommending PA and exercise for stroke prevention, and referral to behaviourally oriented programmes to improve PA and exercise.

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“…However, there is currently a lack of evidence or clinical guidelines for the management or prevention of post-stroke fatigue (McGeough et al, 2009; National Institute of Health and Care Excellence, 2013;Wu et al, 2015b). In a survey of stroke survivors, 43% of respondents reported that they did not feel they were receiving the help that they needed in dealing with fatigue (McKevitt et al, 2011).…”

Section: Introductionmentioning

confidence: 99%