Post-Stroke Fatigue: Epidemiology, Clinical Characteristics and Treatment

Acciarresi, Monica; Bogousslavsky, Julien; Paciaroni, Maurizio

doi:10.1159/000363763

Cited by 976 publications

(85 citation statements)

References 101 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The study results support the reliability and validity of these tests, and demonstrates their superior validity and sensitivity/specificity when compared to the proprioceptive component of the EmNSA. memory; functions which may also be impaired post stroke [42] and may be further confounded by factors such as fatiguea known sequela of stroke [43]. Formal assessments of cognitive function and fatigue were not undertaken in this study, so the extent to which they influenced test outcome cannot be determined.…”

Section: Discussionmentioning

confidence: 99%

Assessing lower limb position sense in stroke using the gradient discrimination test (GradDT™) and step-height discrimination test (StepDT™): a reliability and validity study

Gorst

Freeman

Yarrow

et al. 2019

Disability and Rehabilitation

View full text Add to dashboard Cite

Purpose: To evaluate the psychometric properties of two novel tests of lower limb position sense. Methods: Our newly developed tests assess discrimination thresholds of underfoot slope and step height perception using a two alternative forced choice approach. Stroke participants (n=32) and age matched controls (n=32) were tested. Inter-and intra-rater reliability and agreement, sensitivity and specificity, discriminant and convergent validity were evaluated. Results: Intra-rater reliability for both variants of the gradient discrimination test was excellent: intraclass correlation coefficients (ICC) =0.91 and 0.89. The step height discrimination test had excellent intra-rater reliability and agreement: ICC=0.95. Inter-rater reliability was also excellent in both tests (ICC= 0.85-0.93). Discriminant validity was demonstrated with significant differences in test performance between stroke and control participants (p<0.001). Our novel tests did not significantly correlate with the proprioceptive component of the Erasmus modified Nottingham Sensory Assessment. Receiver Operating Characteristic curve analysis indicated both novel tests to have greater sensitivity and specificity than the proprioceptive component of the Erasmus modified Nottingham Sensory Assessment in predicting the presence of self-reported sensory impairments. Functional Reach Test, 10 metre walk test, Centre of Pressure measurement and reported falls showed significant and moderate to strong correlations with novel test performance (r=0.40-0.60); the Erasmus modified Nottingham Sensory Assessment did not. Conclusion(s): Our novel, functionally oriented tests of lower limb position sense are reliable, valid and feasible for use in an ambulatory chronic stroke and elderly population.

show abstract

Section: Discussionmentioning

confidence: 99%

Assessing lower limb position sense in stroke using the gradient discrimination test (GradDT™) and step-height discrimination test (StepDT™): a reliability and validity study

Gorst

Freeman

Yarrow

et al. 2019

Disability and Rehabilitation

View full text Add to dashboard Cite

show abstract

“…50 Discriminative ability may be further confounded by factors such as fatigue and motivation-known sequelae of stroke. 51 Formal assessment of cognitive functions were not undertaken in this study sample, so the extent to which they influenced test outcome cannot be quantified. That these tests were evaluated in a cohort of chronic stroke also limits their generalizability to the wider stroke population.…”

Section: Study Limitationsmentioning

confidence: 99%

Assessing Plantar Sensation in the Foot Using the Foot Roughness Discrimination Test (FoRDT): A Reliability and Validity Study in Stroke

Gorst

Freeman

Yarrow

et al. 2019

PM&R

View full text Add to dashboard Cite

Background The plantar foot represents a sensory dynamometric map and is essential for balance and gait control. Sensory impairments are common, yet often difficult to quantify in neurological conditions, particularly stroke. A functionally oriented and quantifiable assessment, the Foot Roughness Discrimination Test (FoRDT), was developed to address these shortcomings. Objective To evaluate inter‐ and intrarater reliability, convergent and discriminant validity of the FoRDT. Design Test‐retest design. Setting Hospital outpatient. Participants Thirty‐two people with stroke (mean age 70 years) at least 3 months after stroke, and 32 healthy, age‐matched controls (mean age 70). Main Outcome Measures Roughness discrimination thresholds were quantified utilizing acrylic foot plates, laser cut to produce graded spatial gratings. Stroke participants were tested on three occasions, and by two different raters. Inter‐ and intrarater reliability and agreement were evaluated with Intraclass Correlation Coefficients and Bland‐Altman plots. Convergent validity was evaluated through Spearman rank correlation coefficients (rho) between the FoRDT and the Erasmus modified Nottingham Sensory Assessment (EmNSA). Results Intra‐ and interrater reliability and agreement were excellent (ICC =0.86 [95% CI 0.72‐0.92] and 0.90 [95% CI 0.76‐0.96]). Discriminant validity was demonstrated through significant differences in FoRDT between stroke and control participants (P < .001). Stroke fallers had statistically significant higher FoRDT scores compared with nonfallers (P = .01). Convergent validity was demonstrated through significant and strong correlations (rho) with the Erasmus MC Nottingham Sensory Assessment (r = .69, P < .01). Receiver operator characteristic curve analysis indicated the novel test to have excellent sensitivity and specificity in predicting the presence of self‐reported sensory impairments. Functional Reach test significantly correlated with FoRDT (r = .62, P < .01) whereas measures of postural sway and gait speed did not (r = .16‐.26, P > .05). Conclusions This simple and functionally oriented test of plantar sensation is reliable, valid, and clinically feasible for use in an ambulatory, chronic stroke and older population. It offers clinicians and researchers a sensitive and robust sensory measure and may further support the evaluation of rehabilitation targeting foot sensation. Level of Evidence III.

show abstract

“…The prevalence of fatigue is equally distributed over patients after ischemic stroke and those who had an intracerebral hemorrhage [110]. With respect to inflammation, high levels of circulating IL-6 during the acute phase of stroke have been associated with poor outcome (odds ratio 3.1, 95% CI 1.9–5.0); these data are derived from a large prospective study consisting of 844 patients [111].…”

Section: Overview Of Studies Investigating the Role Of Interleukin-1 mentioning

confidence: 99%

Interleukin-1 as a mediator of fatigue in disease: a narrative review

Roerink

Schaaf

Dinarello

et al. 2017

J Neuroinflammation

View full text Add to dashboard Cite

Fatigue is commonly reported in a variety of illnesses, and it has major impact on quality of life. Previously, it was thought that fatigue originates in the skeletal muscles, leading to cessation of activity. However, more recently, it has become clear that the brain is the central regulator of fatigue perception. It has been suggested that pro-inflammatory cytokines, especially interleukin-1 alpha (IL-1α) and interleukin-1 beta (IL-1β), play a prominent role in the development of central fatigue, and several studies have been performed to elucidate the connection between inflammation and these central processes.In this narrative review, mechanisms of action of IL-1 are described, with special attention to its effect on the central nervous system. In addition, we present a summary of studies that (i) investigated the relationship between circulating IL-1α and IL-1β and fatigue severity and/or (ii) evaluated the effect of inhibiting IL-1 on fatigue. We aim to improve the understanding of fatigue in both inflammatory and non-inflammatory illnesses, which could help develop strategies to treat fatigue more effectively.Reviewing the studies that have been performed, it appears that there is a limited value of measuring circulating IL-1. However, inhibiting IL-1 has a positive effect on severe fatigue in most studies that have been conducted.

show abstract

Post-Stroke Fatigue: Epidemiology, Clinical Characteristics and Treatment

Cited by 976 publications

References 101 publications

Assessing lower limb position sense in stroke using the gradient discrimination test (GradDT™) and step-height discrimination test (StepDT™): a reliability and validity study

Assessing lower limb position sense in stroke using the gradient discrimination test (GradDT™) and step-height discrimination test (StepDT™): a reliability and validity study

Assessing Plantar Sensation in the Foot Using the Foot Roughness Discrimination Test (FoRDT): A Reliability and Validity Study in Stroke

Interleukin-1 as a mediator of fatigue in disease: a narrative review

Contact Info

Product

Resources

About