Post stroke fatigue: Analysis of subtypes and associated factors

Post stroke fatigue (PSF) is a disabling complaint endorses stroke recovery. PSF is highly varied, while most of previous studies did not consider physical and cognitive subtypes. The current study aimed to investigate PSF prevalence and associated factors with consideration of fatigue subtypes.

A cross-sectional study was conducted. Demographics, medical history, stroke characteristics, depression, anxiety, sleep quality, and stroke recovery were evaluated. The Modified Fatigue Impact Scale (MFIS) has been adopted to assess PSF and its subtypes (physical and cognitive). Descriptive statistics, t-tests for MFIS subscales comparisons, and regression analyses were performed.

A total of 92 participants were included; 45 % were female, age ranged between 27 and 85 years. The PSF prevalence rate was 71.7 %. The MFIS physical subscale demonstrated a significantly higher prevalence and severity than cognitive subscale (t = 11.1, p < 0.001). Perceived stroke recovery, depression, anxiety, and sleep quality were related with the MFIS total score as well as its two subscales (B = 0.21-3.32). Diabetes mellitus (B = 0.05, p = 0.02), hypercholesterolemia (B = 0.06, p = 0.018), and left hemisphere stroke (B = -0.04, p = 0.027) were associated with the MFIS cognitive subscale, while recurrent stroke was related to the MFIS physical subscales (B = 0.08, p = 0.04). Anxiety and perceived stroke recovery represented the common significant predictors for MFIS total score and all its subscales (B = 0.13-1.16). Depression and left hemisphere stroke were significant predictors for MFIS total score and cognitive subscale (B = 0.87-7.51). Sleep quality (B = 0.64, p = 0.026) and being male (B = 3.32, p = 0.049) were additional significant predictors for MFIS cognitive fatigue.

PSF is highly prevalent. PSF subtypes were markedly varied in prevalence, severity and associated factors. Future research and clinical protocols should consider different PSF subtypes rather than conceptualizing PSF as one entity.