Minimal and robust clinically important difference of three fatigue measures in chronic stroke survivors

Cheraghifard, Moslem; Sarlak, Nazanin; Taghizadeh, Ghorban; Azad, Akram; Fallah, Soheila; Akbarfahimi, Malahat

doi:10.1080/10749357.2022.2051830

Cited by 5 publications

(2 citation statements)

References 52 publications

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“…Vitality is a parameter of fatigue that was improved in this study. The mean difference in the vitality subdomain can be regarded as clinically relevant [59].…”

Section: Discussionmentioning

confidence: 99%

Feasibility of an Application-Based Outpatient Rehabilitation Program for Stroke Survivors: Acceptability and Preliminary Results for Patient-Reported Outcomes

Bindschedler,

Ziller,

Gerber

et al. 2024

Bioengineering

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Background: The majority of stroke survivors experience long-term impairments. Regular physical activity and other lifestyle modifications play an important role in rehabilitation. Outpatient rehabilitation using telemedicine might be suitable to improve functional ability and long-term secondary prevention. The Strokecoach Intervention Program (SIP, Strokecoach GmbH, Cologne, Germany) comprises training, coaching and monitoring with the aim of improving or at least maintaining functional independence and preventing further stroke through more targeted physical activity. The SIP is provided as blended care, which refers to the integrated and coordinated delivery of healthcare services that combines traditional in-person interactions with technology-mediated interventions, optimizing the use of both face-to-face and virtual modalities to enhance patient outcomes. Objective: The aim of this study was to evaluate the acceptance of the SIP by the participants and its practical application, as well as to obtain initial indications of effects of the SIP on the basis of patient-related outcome measures, blood pressure measurements and recording of physical activity in parallel with the intervention. Methods: Data from individuals with stroke participating in the SIP were analyzed retrospectively. Within the SIP, participants received an application-based training program, were instructed to measure their blood pressure daily and to wear an activity tracker (pedometer). During the intervention period of either 6 or 12 weeks, the participants were supported and motivated by a personal coach via a messenger application. The primary outcomes of the analysis were recruitment, acceptance of and satisfaction with the SIP. Secondary outcomes included functional measures, mobility and health-related quality of life. Results: A total of 122 individuals with stroke could be recruited for the SIP. A total of 96 out of 122 were able to start the program (54% female, mean age 54.8 (SD = 13.1), 6.1 (SD = 6.6) years after stroke onset) and 88 completed the SIP. Participants wore the activity tracker on 66% and tracked their blood pressure on 72% of their intervention days. A further analyzed subgroup of 38 participants showed small improvements in patient-reported outcomes such as health-related quality of life (SF-36) with an increase of 12 points in the subdomain mental health, vitality (12.6) and physical functioning (9.1). However, no statistically significant improvements were found in other performance-based measures (Timed Up and Go test, gait speed). Conclusions: This study showed that a blended therapy approach for stroke survivors with mild to moderate impairments in the chronic phase is feasible and was highly accepted by participants, who benefitted from the additional coaching.

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“…Vitality is a parameter of fatigue that was improved in this study. The mean difference in the vitality subdomain can be regarded as clinically relevant [59].…”

Section: Discussionmentioning

confidence: 99%

Feasibility of an Application-Based Outpatient Rehabilitation Program for Stroke Survivors: Acceptability and Preliminary Results for Patient-Reported Outcomes

Bindschedler,

Ziller,

Gerber

et al. 2024

Bioengineering

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“…The cut-off point for fatigue in stroke patients was set at 24 based on the FAS [ 30 ]. As to internal consistency of the Persian version, Cronbach's alpha coefficient for physical and mental fatigue was 0.945 and 0.896, respectively [ 36 , 37 ].…”

Section: Methodsmentioning

confidence: 99%

The Effects of Vestibular Rehabilitation on Poststroke Fatigue: A Randomized Controlled Trial Study

Ghaffari

Asadi

Zareiyan

et al. 2022

Stroke Research and Treatment

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Background. A major complication caused by stroke is poststroke fatigue (PSF), and by causing limitations in doing activities of daily living (ADL), it can lower the quality of life. Objective. The present study is an attempt to examine the effects of vestibular rehabilitation on BADL (Basic Activities of Daily Living), fatigue, depression, and Lawton Instrumental Activities of Daily Living (IADL) in patients with stroke. Method. Patients with a history of stroke took part voluntarily in a single-blind clinical trial. The participants were allocated to control and experimental groups randomly. The experimental group attended 24 sessions of vestibular rehabilitation protocol, while the control group received the standard rehabilitation (including three sessions per week each for around 60 min). To measure fatigue, the Fatigue Impact Scale (FIS) and the Fatigue Assessment Scale (FAS) were used. Depression, BADL, and IADL were measured using the Beck Depression Inventory-II (BDI-II), Barthel Index (BI), and Lawton Instrumental Activities of Daily Living, respectively. All changes were measured from the baseline after the intervention. Results. Significant improvement was found in the experimental group compared to the control group ( p < 0.05 ) in FIS (physical, cognition, and social subscales), FAS, BDI-II, BADL, and IADL. Moreover, the results showed small to medium and large effect sizes for the physical subscale of FIS and FAS scores based on Cohen’s d , respectively; however, no significant difference was found in terms of cognition and social subscales of FIS, BDI-II, BADL, and IADL scores. Conclusion. It is possible to improve fatigue, depression, and independence in BADL and IADL using vestibular rehabilitation. Thus, it is an effective intervention in case of stroke, which is also well tolerated.

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Minimal and robust clinically important differences for patient-reported outcome measures of fatigue in chronic stroke survivors after fatigue rehabilitation

Fallah,

Taghizadeh,

Taghavi-Azar-Sharabiani

et al. 2024

Disability and Rehabilitation

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Minimal and robust clinically important difference of three fatigue measures in chronic stroke survivors

Cited by 5 publications

References 52 publications

Feasibility of an Application-Based Outpatient Rehabilitation Program for Stroke Survivors: Acceptability and Preliminary Results for Patient-Reported Outcomes

Feasibility of an Application-Based Outpatient Rehabilitation Program for Stroke Survivors: Acceptability and Preliminary Results for Patient-Reported Outcomes

The Effects of Vestibular Rehabilitation on Poststroke Fatigue: A Randomized Controlled Trial Study

Minimal and robust clinically important differences for patient-reported outcome measures of fatigue in chronic stroke survivors after fatigue rehabilitation

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