Problems with balance and binocular visual dysfunction are associated with post-stroke fatigue

Fatigue after stroke is hard to define and measure and how it is associated with other complications after stroke still needs to be explored. These issues are relevant in stroke rehabilitation and in the patient's daily life.

To investigate fatigue after stroke and its relation to balance, gait, and Binocular Visual Dysfunction (BVD).

Adults with stroke (n = 29, age 18-67 years) were tested with the Modified Fatigue Impact Scale (MFIS), objective and subjective BVD measures, Balance Evaluation Systems Test, Ten Meter Walk Test, and a Health-Related Quality of Life questionnaire, before and after a four-month intervention program and at three- and six-month follow-ups. We used principle component analysis to extract underlying factors of MFIS. Associations between MFIS factors and patient characteristics were analyzed by repeated measures ANOVA. The associations between MFIS factors and physical measures were assessed using pairwise correlations.

Three components were extracted from the MFIS, explaining 71% of variance: Cognitive fatigue, Physical fatigue and Arousal. We found that women register higher MFIS scores than men. There was a strong association between the level of Cognitive and Physical Fatigue and BVD, between Arousal and balance and dizziness, and between Cognitive Fatigue and gait.

The three extracted components of MFIS proved clinically informative. The arousal component revealed particularly interesting results in studying fatigue. The correlation analysis shown at this component differs from cognitive and physical fatigue and describes another aspect of PSF, important in future treatment and research.