Long-term mental fatigue after traumatic brain injury and impact on employment status

Palm, Samuel; Rönnbäck, Lars; Johansson, Birgitta

doi:10.2340/16501977-2190

Cited by 53 publications

(49 citation statements)

References 32 publications

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“…Moreover, only mental fatigue was significantly related to unfavorable long-term functional outcome after SAH, compared to physical fatigue and mood problems. In this study, mental fatigue was identified as an important factor post-SAH, in line with previous studies defining mental fatigue as most distinctive for brain injury [9,10]. Despite some overlap, our data support a distinction between mental and physical fatigue.…”

Section: Discussionsupporting

confidence: 91%

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Mental versus physical fatigue after subarachnoid hemorrhage: differential associations with outcome

Buunk

Groen

Wijbenga

et al. 2018

Euro J of Neurology

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Background and purposeFatigue 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.MethodsPatients 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.ResultsFrequencies 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 χ 2 = 52.99, P < 0.001; Nagelkerke R² = 0.32).ConclusionsMental 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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Section: Discussionsupporting

confidence: 91%

“…In this study, mental fatigue was identified as an important factor post‐SAH, in line with previous studies defining mental fatigue as most distinctive for brain injury . Despite some overlap, our data support a distinction between mental and physical fatigue.…”

Section: Discussionsupporting

confidence: 91%

Mental versus physical fatigue after subarachnoid hemorrhage: differential associations with outcome

Buunk

Groen

Wijbenga

et al. 2018

Euro J of Neurology

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“…Family and social life can also be affected, as the symptoms can be triggered in any situation requiring even small amounts of mental and/or physical effort. On the socioeconomic level, PCS is related to prolonged sick leave and unemployment [12] [13].…”

Section: Introductionmentioning

confidence: 99%

Nature-Based Therapy for People Suffering from Post-Concussion Syndrome—A Pilot Study

Corazon

Olsen

et al. 2019

Health

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Background: Approximately 10%-15% of people diagnosed with a concussion develop post-concussion syndrome (PCS), in which mental fatigue is a dominating symptom. PCS has major consequences for the individuals diagnosed, and society as a whole. Objective: The objective of the pilot study was to investigate whether a nature-based therapeutic (NBT) intervention would be suitable for ameliorating the symptoms experienced by people with PCS, especially mental fatigue. Method: Eight participants diagnosed with PCS took part in a NBT programme, which consisted of weekly two-hour sessions over the course of eight weeks. The participants' level of mental fatigue was measured on the Mental Fatigue Scale (MFS) before and after the intervention. An analogue scale inspired by the EuroQol-visual analogue scales (EQ-VAS) was used to measure immediate self-perceived feeling of health/ well-being before and after individual sessions. A semi-structured interview was held with each participant after the intervention. The interviews and logbooks were analysed through content analysis, which entails several steps in a spiral-like process, from reading and re-reading the transcripts to forming units of meaning, which were then grouped into sub-categories and categories for further analysis. Result: The MFS showed a significant decrease in mental fatigue and large effect size. The participants' self-assessed health/ well-being on the analogue scale showed an increase from the beginning to the end of each session. The analysis of the interviews revealed that the participants experienced the sensory stimuli and exercises in the natural environment as motivating and meaningful, even when they were challenging. Further, they found the psycho-educational aspects transferable to everyday life. Conclusion: The results support that NBT can have potential in the rehabilitation of PCS, by lowering mental fatigue and improving health

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“…F atigue is common in the early phase of recovery after stroke (reported by 23-75% of people) (1) and continues to affect daily life in the chronic phase after stroke (termed "post-stroke fatigue"; PSF). PSF affects the individual's everyday life (2), functioning, and can negatively interfere with rehabilitation (1,3). However, there is insufficient evidence regarding the efficacy of any non-pharmacological intervention for PSF (4)(5)(6)(7).…”

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confidence: 99%

Nature-based rehabilitation to reduce post-stroke fatigue is not effective: A randomized controlled trial

Pálsdóttir¹,

Stigmar²,

Norrving³

et al. 2020

J Rehabil Med

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We have performed the first randomized controlled study on a nature-based intervention for patients with post stroke fatigue. Nature Based Interventions are performed in outdoor environment especially suitable/ adopted for supporting treatment and rehabilitation programs. A total of 101 patients were randomized into a two-armed study: 1) treatment as usual, and 2) nature-based intervention. There were no statistical differences confirmed between the treatments, which may be partly explained by several methodological issues. However, participants showed good compliance with the nature-based intervention; thus, this study contributes with new knowledge to the field of stroke rehabilitation and is ground for further studies on how nature can support recovery from post-stroke fatigue. Objective: To determine whether nature-based rehabilitation, as an add-on to standard care, has a longterm influence on post-stroke fatigue, perceived value of everyday occupations, disability, healthrelated quality of life, anxiety, and depression at follow-up 8 and 14 months after randomization. Design: Single-blinded, 2-armed, randomized controlled trial. Methods: Stroke survivors, identified through routine 3-month follow-up visit (sub-acute) or medical records (chronic stroke > 1 year previously), were randomized to standard care + nature-based rehabilitation (intervention group) or standard care alone (control group). Blinded evaluations were conducted at follow-up 8 and 14 months after randomization, for the following outcomes: post-stroke fatigue (Mental Fatigue Scale; MFS), perceived value of everyday occupations (Occupational value instrument with predefined items), disability (modified Rankin Scale; mRS), health-related quality of life (Euro-QoL-5 Demension Questionnaire), anxiety (Hospital Anxiety and Depression Scale; HAD) and depression (HAD). Results: Approximately one-quarter of the screened patients were eligible for inclusion in the study; of these, half agreed to participate; a final total of 101 patients were randomized (mean age 67 years, 60% female). The patients with sub-acute stroke were highly compliant with the intervention. The participants in both the intervention and control groups improved, However, no statistically significant differences in improvement were found between the intervention and control groups for any of the outcome measures. Fatigue decreased to a value below the suggested cutoff for mental fatigue (< 10.5) in the intervention group, but not in the control group. Conclusion: Nature-based rehabilitation is feasible and well tolerated. A larger randomized controlled trial is warranted.

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Long-term mental fatigue after traumatic brain injury and impact on employment status

Cited by 53 publications

References 32 publications

Mental versus physical fatigue after subarachnoid hemorrhage: differential associations with outcome

Mental versus physical fatigue after subarachnoid hemorrhage: differential associations with outcome

Nature-Based Therapy for People Suffering from Post-Concussion Syndrome—A Pilot Study

Nature-based rehabilitation to reduce post-stroke fatigue is not effective: A randomized controlled trial

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