Post-stroke fatigue and its dimensions over the second half year after stroke

Introduction: Post-stroke fatigue (PSF) is a common and often debilitating sequel of both ischemic and hemorrhagic strokes. The aim: Assess the rates and intensities of PSF over the second half year after stroke.

Materials and methods: There were examined 128 patients at 6, 9 and 12 months after ischemic or hemorrhagic stroke onset. PSF was measured by fatigue assessment scale (FAS), multidimensional fatigue inventory-20 (MFI-20) and fatigue severity scale (FSS). Distributions of continuous variables were checked by Shapiro-Wilk test. Parametric variables were represented as mean±standard deviation, non-parametric - as mediana (Me) and interquartile (25%-75%) range (Q1-Q3). Categorical data were represented by number (n) and percentage. The difference between the patients' proportions with PSF at definite time points after stroke onset was assessed using Cochran's Q-test. The Friedman F-test for repeated measurements was performed to analyze multiple non-parametric variables. When the Friedman F-test yielded a significant effect (p<0,05), it was followed by Dunnett's test for determination the differences between initial and subsequent measurements. A p-value <0,05 was considered statistically significant.

Results: According to FAS and MFI-20 "global fatigue" sub-scale, PSF rates over the second half year after stroke were statistically stable and were present, respectively, in 28,1% and 34,0% at 6 months, in 26,2% and 32,4% at 9 months, in and 32,0% and 30,5% cases at 12 months after stroke. Physical, mental, activity-related and motivational PSF domains, due to MFI-20 sub-scales, had roughly similar percentage without any significant dynamics over the studied period. According to FSS value ranks, proportions of patients with different levels of PSF impact on daily life were statistically stable over the studied post-stroke period. However, it has been revealed significant reduction of PSF intensities in physical and activity-related domains whereas severities of mental and motivational PSF aspects have been statistically increased.

Conclusions: Rates of PSF were stable over the second half year after stroke occurrence, however intensities of mental and motivational PSF domains have been statistically increased, whereas severities of physical and activity-related PSF domains have been significantly decreased.