Predictors and short‐term outcomes of post‐stroke fatigue in initial phase of transition from hospital to home: A prospective observational study

Su, Ya; Asamoto, Mitsuko; Yuki, Michiko; Saito, Masaru; Hasebe, Naoko; Hirayama, Kengo; Otsuki, Mika; Iino, Chieko

doi:10.1111/jan.14731

Cited by 12 publications

(10 citation statements)

References 85 publications

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“…Notably, when fatigue and sleep difficulties were entered into the logistic regression together, it was fatigue that was the contributing factor accounting for increased odds of PSD. Fatigue and sleep difficulties are highly correlated, and both can contribute to poststroke depression such that sleep deprivation worsens mood when the body cannot refresh, and when the body feels tired, the mind can have less reserve to fight ruminations and worries [ 27 ] further contributing to depression. Importantly, the American Heart Association Council on Cardiovascular and Stroke Nursing and Stroke Council made it a point of emphasis to find effective interventions for fatigue that can be disabling and can limit recovery after stroke [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

Biological, Psychiatric, Psychosocial, and Cognitive Factors of Poststroke Depression

Dulay

Criswell

Hodics

2023

IJERPH

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Background: Depression is the most common psychiatric condition that occurs after cerebrovascular accident, especially within the first year after stroke. Poststroke depression (PSD) may occur due to environmental factors such as functional limitations in daily activities, lower quality of life, or biological factors such as damage to areas in the brain involved in emotion regulation. Although many factors are hypothesized to increase the risk of PSD, the relative contribution of these factors is not well understood. Purpose: We evaluated which cross-sectional variables were associated with increased odds of PSD in our adult outpatient stroke neuropsychology clinic population. Methods: The sample included 325 patients (49.2% female; mean age of 59-years old) evaluated at an average of 8.1 months after an ischemic or hemorrhagic stroke. Variables included in logistic regression were stroke characteristics, demographics, psychosocial factors, comorbid medical problems, comorbid psychiatric conditions, and cognitive status. The Mini International Neuropsychiatric Inventory was used to determine DSM-defined PSD and anxiety disorders. A standard neuropsychological test battery was administered. Results: PSD occurred in 30.8% of the sample. Logistic regression indicated that increased odds of PSD were associated with a comorbid anxiety disorder (5.9 times more likely to suffer from PSD, p < 0.001). Further, increased odds of PSD were associated with a history of depression treatment before stroke (3.0 times more likely to suffer from PSD), fatigue (2.8 times more likely), memory impairment (2.4 times more likely), and younger age at stroke (all p values < 0.006). Discussion: Results suggest that PSD is likely multifactorial and extends the literature by demonstrating that a comorbid anxiety disorder correlated strongest with PSD. Poststroke screening and treatment plans should address not only depression but comorbid anxiety.

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Section: Discussionmentioning

confidence: 99%

Biological, Psychiatric, Psychosocial, and Cognitive Factors of Poststroke Depression

Dulay

Criswell

Hodics

2023

IJERPH

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“…The Fatigue Assessment Scale is a short 10-item self-report scale evaluating symptoms of chronic fatigue, with a high internal consistency of 0.90 ( 33 ). It has been used in many diseases including stroke and is the only fatigue measure that has a cut-off score for stroke patients (≥24 indicating post-stroke fatigue) ( 34 ).…”

Section: Discussionmentioning

confidence: 99%

Addressing mood and fatigue in return-to-work programmes after stroke: a systematic review

Chen,

Dong,

Kua

2023

Front. Neurol.

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IntroductionReturn-to-work is a key rehabilitation goal for many working aged stroke survivors, promoting an overall improvement of quality of life, social integration, and emotional wellbeing. Conversely, the failure to return-to-work contributes to a loss of identity, lowered self-esteem, social isolation, poorer quality of life and health outcomes. Return-to-work programmes have largely focused on physical and vocational rehabilitation, while neglecting to include mood and fatigue management. This is despite the knowledge that stroke results in changes in physical, cognitive, and emotional functioning, which all impact one’s ability to return to work. The purpose of this systematic review is to conduct a comprehensive and up-to-date search of randomised controlled trials (RCTs) of return-to-work programmes after stroke. The focus is especially on examining components of mood and fatigue if they were included, and to also report on the screening tools used to measure mood and fatigue.MethodSearches were performed using 7 electronic databases for RCTs published in English from inception to 4 January 2023. A narrative synthesis of intervention design and outcomes was provided.ResultsThe search yielded 5 RCTs that satisfied the selection criteria (n = 626). Three studies included components of mood and fatigue management in the intervention, of which 2 studies found a higher percentage of subjects in the intervention group returning to work compared to those in the control group. The remaining 2 studies which did not include components of mood and fatigue management did not find any significant differences in return-to-work rates between the intervention and control groups. Screening tools to assess mood or fatigue were included in 3 studies.ConclusionOverall, the findings demonstrated that mood and fatigue are poorly addressed in rehabilitation programmes aimed at improving return-to-work after stroke, despite being a significant predictor of return-to-work. There is limited and inconsistent use of mood and fatigue screening tools. The findings were generally able to provide guidance and recommendations in the development of a stroke rehabilitation programme for return-to-work, highlighting the need to include components addressing and measuring psychological support and fatigue management.

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“…In addition, the consumption of skeletal muscle content will lead to a lack of energy and a feeling of general weakness, and the further fatigue reaction will directly reduce physical activity, good mental state, and physical recovery speed, forming an adverse cycle of reduced ADL and increasing risk of stroke recurrence. [25] A survey of the elderly in Chinese communities [26] also showed that sarcopenia accounted for a considerable proportion (25%) in the elderly cohort and was independently associated with disability and poor ADL. Chen et al [27] found in the hip fracture cohort that sarcopenia significantly reduced ADL in patients with hip fracture, especially men.…”

Section: Discussionmentioning

confidence: 99%

Long-term prognostic significance of sarcopenia in acute ischemic stroke

Hou

Liu

2022

Medicine

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Because sarcopenia is widely distributed in patients with acute ischemic stroke (AIS) and has not attracted enough attention, this study aims to explore the relationship between sarcopenia defined by temporal muscle thickness (TMT) and physical function and prognosis of patients with AIS. A total of 265 hospitalized nonsurgical AIS patients from 2015 to 2018, with an age range of 28 ~ 92, were analyzed retrospectively. The median value of TMT was used as the risk classification index of sarcopenia. The main results were the relationship between sarcopenia and Essen Stroke Risk Score, National Institutes of Health Stroke Scale, modified Rankin Score, water swallow test, venous thromboembolism assessment of medical inpatients, activities of daily living assessed by Barthel Index, and the relationship between TMT and final survival outcome. The mean TMT of men in the study cohort was higher than that of women. The measured values of TMT among different researchers had good consistency (intraclass correlation coefficient, 0.980; P < .001). After adjusting for confounding variables, logistic regression showed that sarcopenia was associated with Essen Stroke Risk Score (odds ratio, 1.89; P < .05) and Barthel Index (odds ratio, 1.67; P < .05). Kaplan-Meier analysis showed that the survival time of low TMT group was significantly lower than that of high TMT group (36 vs 49 months; P < .001). Multivariate Cox regression showed that there was causal correlation between sarcopenia and patient death (hazard ratio, 3.54; 95% confidence interval, 1.46–8.58; P < .01). As a potential comprehensive index, thickness of temporal muscle can be included in baseline evaluation to show the physical status, stroke recurrence, and survival prognosis of AIS patients.

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Predictors and short‐term outcomes of post‐stroke fatigue in initial phase of transition from hospital to home: A prospective observational study

Cited by 12 publications

References 85 publications

Biological, Psychiatric, Psychosocial, and Cognitive Factors of Poststroke Depression

Biological, Psychiatric, Psychosocial, and Cognitive Factors of Poststroke Depression

Addressing mood and fatigue in return-to-work programmes after stroke: a systematic review

Long-term prognostic significance of sarcopenia in acute ischemic stroke

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