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Evaluating Test-Retest Reliability of Fatigability in Chronic Stroke.

Alyssa D Stookey¹, Richard F Macko², Frederick M Ivey³

¹Geriatric Research, Education and Clinical Center (GRECC), VA Maryland Health Care System, Baltimore, MD, United States; Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, United States.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association

|July 9, 2021

Summary

This study shows that measuring fatigability during the 6-minute walk test (6MW) is a reliable way to assess fatigue in stroke survivors. Objective fatigability measures correlate strongly with walking performance and aerobic capacity.

Keywords:

Function Rehabilitation Stroke Task performance and analysis

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Area of Science:

Neurology
Rehabilitation Medicine
Exercise Physiology

Background:

Post-stroke fatigue is subjectively reported, leading to variable prevalence rates.
Objective measures of performance fatigue may provide a more consistent assessment of fatigue in stroke survivors.

Purpose of the Study:

To determine the test-retest reliability of fatigability measured during the 6-minute walk (6MW) test in individuals with hemiparetic stroke.
To explore the relationships between stroke-related fatigability and other functional and physiological measures.

Main Methods:

Twenty-three hemiparetic stroke survivors completed two 6MW tests at least 48 hours apart.
Fatigability was calculated as the ratio of change in walking speed to distance covered during the 6MW.
Measurements included oxygen consumption (VO2), peak aerobic capacity (VO2peak), walking speed, Dynamic Gait Index (DGI), and subjective fatigue.

Main Results:

Fatigability demonstrated high test-retest reliability (ICC = 0.99, p < 0.001) with no significant difference between trials.
Strong correlations were found between fatigability and 6MW oxygen consumption (VO2) (r = 0.92-0.95, p < 0.001).
Moderate-to-strong relationships were observed between fatigability and various walking speeds, VO2peak, and DGI (r = -0.47 to -0.82, p < 0.001).

Conclusions:

The 6MW test provides a reliable and objective method for assessing fatigability in stroke survivors.
Fatigability is closely linked to functional mobility and aerobic capacity in this population, offering insights into underlying contributors.