Prevalence of fatigue after stroke: A systematic review and meta-analysis

Abstract

Background and Purpose Post-stroke fatigue is a debilitating and long-lasting condition. However, there are uncertainties regarding its prevalence and variability between studies. This review aims to estimate the prevalence of fatigue and determine the factors responsible for its variation in the literature. Methods A systematic review was conducted for all published studies (search to November 2020) using AMED, CINAHL, EMBASE, MEDLINE, PsycINFO, SCOPUS and Web of Science. Papers were included if they recruited participants with stroke, used a validated scale to measure fatigue and were in English. Two reviewers screened and assessed the relevant studies for eligibility ( n = 96). The included papers were appraised using the Joanna Briggs Institute (JBI) tool for prevalence studies, and data were extracted by one reviewer. To understand the variation in PSF prevalence between papers, data were pooled and analysed based on relevant methodological (e.g. time of assessment) or clinical factors (e.g. depression) using Review Manager 5.4 software. Results While 48 studies were included and summarised ( N = 9004), only 35 were appropriate for the meta-analysis ( N = 6851). The most frequently used tool to measure fatigue was the Fatigue Severity Scale (FSS) ( n = 31). The prevalence was calculated with a cut-off point of four or more using FSS and resulted in an estimate of 48% (95% CI 42–53%). Time of assessment (<6 vs ≥6 months), stroke type (ischaemic vs haemorrhagic/subarachnoid haemorrhage) and geographical location (East Asia vs Europe) could explain the prevalence variation between studies. Conclusions Fatigue is prevalent among stroke survivors. This condition varies in terms of occurrence between studies; however, time of assessment, stroke type and geographical location might explain this variation. As this review estimates the overall burden of fatigue after stroke, it provides a useful indicator to inform policy, planning and healthcare professionals. Further efforts are required to investigate the mechanisms that lead to PSF, particularly in the groups that show high prevalence, in order to prevent or alleviate it.

The relationship between red blood cell distribution width at admission and post-stroke fatigue in the acute phase of acute ischemic stroke

“…The incidence of PSF in the acute phase is 34.0 % in our study, which is in line with previous studies ( 7 – 11 ). This may be attributed to our rigorous and meticulous assessment about PSF during this prospective study.…”

“…Although there are many treatment options for ischemic stroke nowadays (4)(5)(6), the AIS patients may undergo several complications during their treatment and rehabilitation. Post-stroke fatigue (PSF), whose incidence range from 23 to 85%, is a common emotional complication after the onset of AIS (7)(8)(9)(10)(11). PSF could lead to poor recovery and prognosis (7)(8)(9)(10)(11).…”

Brain-machine interface-based training for improving upper extremity function after stroke: A meta-analysis of randomized controlled trials

“…Only three studies reported minor adverse effects that were reversed after treatment. Fatigue is one of the most common symptoms of post-stroke (Alghamdi et al, 2021 ). Most of the studies included in the meta-analysis had 30-min or longer interventions, and patients needed to maintain their attention during training, which tended to induce fatigue.…”

“I Give It Everything for an Hour Then I Sleep for Four.” The Experience of Post-stroke Fatigue During Outpatient Rehabilitation Including the Perspectives of Carers: A Qualitative Study

“…Fatigue is associated with dependence in daily activities, poor quality of life ( 2 ), reduced physical activity ( 3 ), and increased morbidity and mortality ( 4 ). Approximately half of all stroke survivors experience fatigue ( 5 ), regardless of severity ( 6 ). Optimizing motor recovery post-stroke requires high-dose rehabilitation ( 7 , 8 ).…”