Post-stroke fatigue: a scoping review

Area of Science:

• Neurology
• Rehabilitation Medicine
• Evidence Synthesis

Background:

• Post-stroke fatigue (PSF) is a prevalent and enduring condition following stroke.
• PSF significantly impairs multiple aspects of a patient's daily life and overall well-being.
• Existing evidence on PSF requires updating to reflect recent research findings.

Purpose of the Study:

• To systematically review and synthesize recent research on post-stroke fatigue.
• To update the evidence base concerning PSF interventions and associated factors.
• To identify any new clinical practice guidelines related to PSF.

Main Methods:

• An updated systematic review methodology was employed, searching major databases (CINAHL, MEDLINE, PsycINFO, PubMed) for studies published between March 2016 and January 2020.
• Included interventional studies, observational research, and clinical practice guidelines not covered in the prior review.
• Risk of bias assessment was conducted for randomized trials using both automated (RobotReviewer) and human review.

Main Results:

• The review identified 30 studies (14 observational, 10 interventional, 6 guidelines).
• Interventional studies were often single-centered, had a high risk of bias, and small sample sizes, investigating various therapeutic approaches.
• Observational studies identified numerous factors associated with PSF, including comorbidities, psychological status, quality of life, and stroke severity.

Conclusions:

• Recent studies have contributed to understanding PSF, but none provide robust evidence to change current clinical practice.
• The quality and sample sizes of interventional studies limit their impact on clinical recommendations.
• Further high-quality research is needed to inform effective management strategies for post-stroke fatigue.