Top Things to Know: Poststroke Fatigue: Emerging Evidence and Approaches to Management
Published: May 25, 2017
- Poststroke fatigue (PSF) is common and affects at least half of stroke survivors.
- The goal of this scientific statement is to provide an international view on the current understanding of the incidence, prevalence, quality of life and etiology of poststroke fatigue.
- Defining PSF has been challenging, with no consensus among clinicians or researchers on one best definition of PSF. A consensus definition would lead to more accurate estimates of incidence and prevalence.
- Depression and poststroke fatigue may be two separate conditions.
- Regarding quality of life in PSF, clinicians, researchers, patients and caregivers all consider PSF important as it affects quality of life.
- Multidimensional aspects of PSF including demographic, neurological/physical deficits, medical comorbidities, smoking, medications, sleep disturbances, pain, prestroke fatigue, depression, anxiety, and cognitive impairment may all play a part in PSF.
- The pathophysiology of PSF is not well understood. Several ideas are presented in this paper as possibilities for the development of PSF, such as altered cortical excitability and stroke lesion location, inflammation, and immune response as well as genes.
- Patient assessment for PSF is important so that potential remedies can be instituted.
- Pharmacologic and non-pharmacologic issues are discussed in this paper as potential treatments for PSF. The effect on caregiver burden is also discussed. Interventions such as patient and caregiver education may help ameliorate this condition.
- Clinicians should be aware of poststroke fatigue, and assess patients accordingly for it. There are potential interventions that may be instituted if PSF is diagnosed. Instituting those interventions may help with patient and caregiver quality of life.
Citation
Hinkle JL, Becker KJ, Kim JS, Choi-Kwon S, Saban KL, McNair N, Mead GE; on behalf of the American Heart Association Council on Cardiovascular and Stroke Nursing and Stroke Council. Poststroke fatigue: emerging evidence and approaches to management: a scientific statement for healthcare professionals from the American Heart Association [published online ahead of print May 25, 2017]. Stroke. doi: 10.1161/STR.0000000000000132.