Service de Médecine Physique et de Réadaptation, Pôle Neurosciences - tête et cou, Hôpital J. Rebeyrol, CHU Limoges, Limoges, France.
Top Stroke Rehabil. 2012 Sep-Oct;19(5):369-76. doi: 10.1310/tsr1905-369.
To look for a relationship between physical fatigue and physical parameters in patients at least 3 months post stroke.
We conducted a prospective cross-sectional study of 32 poststroke patients (average duration of stroke 40 months) who were recruited among in- and outpatients followed by the Department of Physical and Rehabilitation Medicine of a university hospital. Fatigue was defined as a Fatigue Severity Scale (FSS) score of 4 or more. The parameters studied were age, sex, time since stroke, Demeurisse Motor Index, Barthel Index score, new Functional Ambulation Category, Berg Balance Scale, 10-meter walk test, 6-minute walk test, Dijon Physical Activity Score, Montgomery and Asberg Depression Rating Scale, Epworth Sleepiness Scale, presence of pain, and length and area of the center of pressure displacement obtained posturographically.
Two-thirds of patients (65.6%) were fatigued. The mean FSS score was 4.3 ± 1.8. Fatigue was not associated with the physical parameters studied; notably, there was no correlation with motor impairment, autonomy and walking capacity, or balance and physical activity. However, after multivariate analysis, we found an association between physical fatigue and time since the occurrence of stroke (P = .05).
Our study revealed a relationship between pain and physical fatigue, as reported by 2 other studies. Poststroke fatigue management should include appropriate pain management. Further studies are necessary to determine the causes of physical fatigue after stroke.
寻找至少 3 个月后脑卒中患者身体疲劳与身体参数之间的关系。
我们进行了一项前瞻性的脑卒中患者横断面研究，共纳入 32 名患者（脑卒中平均病程 40 个月），均为我院物理康复医学科的门诊和住院患者。疲劳的定义为疲劳严重程度量表（FSS）评分≥4 分。研究的参数包括年龄、性别、脑卒中发病时间、德梅里塞运动指数、巴氏指数评分、新的功能性步行分类、伯格平衡量表、10 米步行测试、6 分钟步行测试、第戎体力活动评分、蒙哥马利和阿斯伯格抑郁评定量表、嗜睡量表、疼痛的存在以及姿势反射测试中获得的压力中心位移的长度和面积。
三分之二的患者（65.6%）感到疲劳。平均 FSS 评分为 4.3±1.8。疲劳与研究的身体参数无关；特别是，与运动障碍、自主性和步行能力或平衡和体力活动均无相关性。然而，经多变量分析，我们发现身体疲劳与脑卒中发病时间之间存在关联（P=0.05）。
我们的研究发现疼痛与身体疲劳之间存在关联，这与另外两项研究的报道一致。脑卒中后疲劳的管理应包括适当的疼痛管理。需要进一步的研究来确定脑卒中后身体疲劳的原因。
