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

Hinkle, Janice L.; Becker, Kyra J.; Kim, Jong Seung; Choi-Kwon, Smi; Saban, Karen L.; McNair, Norma D.; Mead, Gillian

doi:10.1161/str.0000000000000132

Cited by 142 publications

(167 citation statements)

References 128 publications

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“…However, mental fatigue and physical fatigue were more prevalent than mood disorders; ergo, a significant proportion of SAH patients with mental or physical fatigue were not depressed or anxious. This is all in line with findings in other subtypes of stroke, in which the theoretical distinction between fatigue on the one side and depression or anxiety on the other side is supported . Furthermore, higher levels of mental, not physical, fatigue were found in aSAH patients in the present study.…”

Section: Discussionsupporting

confidence: 93%

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: 93%

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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“…14 There was general overlap between the consumer and health care provider priorities except for the topic of fatigue. While the Working Group acknowledged the high prevalence and considerable impact of fatigue, they felt that fatigue was not adequately treated in part due to the lack of effective treatments at this time, [15][16] and hence a need for further primary research rather than implementation activities. The topic of social isolation was also frequently raised by consumers, and to a lesser extent by healthcare providers and may reflect a lack of knowledge on how to assess or treat social isolation, or implement available treatments.…”

Section: Discussionmentioning

confidence: 99%

Moving Stroke Rehabilitation Research Evidence into Clinical Practice: Consensus-Based Core Recommendations From the Stroke Recovery and Rehabilitation Roundtable

Eng

Bird

Godecke

et al. 2019

Neurorehabil Neural Repair

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Moving research evidence to practice can take years, if not decades, which denies stroke patients and families from receiving the best care. We present the results of an international consensus process prioritizing what research evidence to implement into stroke rehabilitation practice to have maximal impact. An international 10-member Knowledge Translation Working Group collaborated over a six-month period via videoconferences and a two-day face-to-face meeting. The process was informed from surveys received from 112 consumers/family members and 502 health care providers in over 28 countries, as well as from an international advisory of 20 representatives from 13 countries. From this consensus process, five of the nine identified priorities relate to service delivery (interdisciplinary care, screening and assessment, clinical practice guidelines, intensity, family support) and are generally feasible to implement or improve upon today. Readily available website resources are identified to help health care providers harness the necessary means to implement existing knowledge and solutions to improve service delivery. The remaining four priorities relate to system issues (access to services, transitions in care) and resources (equipment/technology, staffing) and are acknowledged to be more difficult to implement. We recommend that health care providers, managers, and organizations determine whether the priorities we identified are gaps in their local practice, and if so, consider implementation solutions to address them to improve the quality of lives of people living with stroke.

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“…Several studies have described fatigue from strokes as a physical experience that starts at stroke onset and continues for months after the stroke. They have further identified a lack of understanding of fatigue by ISSs once they are home (Hinkle et al., ). This study corroborates findings that fatigue was prevalent and consequential after discharge.…”

Section: Discussionmentioning

confidence: 99%

Stroke survivors’ experiences transitioning from hospital to home

Connolly

Mahoney

2018

Journal of Clinical Nursing

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

Cited by 142 publications

References 128 publications

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

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

Moving Stroke Rehabilitation Research Evidence into Clinical Practice: Consensus-Based Core Recommendations From the Stroke Recovery and Rehabilitation Roundtable

Stroke survivors’ experiences transitioning from hospital to home

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