卒中后疲劳的探索性纵向队列研究。

Exploratory longitudinal cohort study of associations of fatigue after stroke.

机构信息

From the School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, United Kingdom (F.D.); Geriatric Medicine (S.J.L., A.M.J.M., G.E.M.) and Division of Clinical Neurosciences (M.S.D.), University of Edinburgh, Edinburgh, United Kingdom; Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham, United Kingdom (C.A.G.); and Department of Psychiatry, University of Oxford, Oxford, United Kingdom (M.S.).

出版信息

Stroke. 2015 Apr;46(4):1052-8. doi: 10.1161/STROKEAHA.114.008079. Epub 2015 Feb 12.

DOI:10.1161/STROKEAHA.114.008079

PMID:25677595

Abstract

BACKGROUND AND PURPOSE

The pathogenesis of poststroke fatigue is unclear. In this prospective study, we explored whether reduced physical activity might contribute to poststroke fatigue or be a consequence of it.

METHODS

Patients with a recent acute stroke were assessed at 1, 6, and 12 months with, Fatigue Assessment Scale (FAS), a fatigue case definition, Hospital Anxiety and Depression Score, sleepiness, quality of life, and accelerometry (ActivPAL). Bivariate analyses determined associations between fatigue and step count at each time point. Multiple linear regression tested whether 1-month step count independently predicted 6- and 12-month FAS.

RESULTS

A total of 136 participants (mean age, 72 years; 64% men) attended ≥1 assessment. ActivPAL data were available for 84 (64%), 69 (66%), and 58 (64%) participants at 1, 6, and 12 months, respectively. At 6 and 12 months, a positive fatigue case definition was associated with lower daily step counts (P=0.014 and 0.013, respectively). At 1, 6, and 12 months, higher FAS (more fatigue) was associated with lower step count (P<0.001, 0.01, and 0.007), higher depression (P<0.001), anxiety scores (P<0.001) and sleepiness (P<0.001), and poorer quality of life (P<0.001). Lower daily step count (P<0.002 and 0.006) and greater anxiety (P<0.001 for both) at 1 month independently predicted higher FAS at 6 and 12 months.

CONCLUSIONS

Lower step counts at 1 month independently predicted greater FAS for ≤12 months. Physical activity might be a therapeutic target for poststroke fatigue.

摘要

背景与目的

脑卒中后疲劳的发病机制尚不清楚。在这项前瞻性研究中，我们探讨了体力活动减少是否是导致脑卒中后疲劳的原因，或者是否是其后果。

方法

近期发生急性脑卒中的患者在 1、6 和 12 个月时使用疲劳评估量表（FAS）、疲劳病例定义、医院焦虑和抑郁量表、嗜睡、生活质量和加速度计（ActivPAL）进行评估。在每个时间点，双变量分析确定疲劳与步数之间的关联。多元线性回归检验了 1 个月时的步数是否能独立预测 6 个月和 12 个月时的 FAS。

结果

共有 136 名（平均年龄 72 岁，64%为男性）患者参加了至少 1 次评估。在 1、6 和 12 个月时，84（64%）、69（66%）和 58（64%）名患者分别有 ActivPAL 数据。在 6 个月和 12 个月时，阳性疲劳病例定义与每日步数较低相关（P=0.014 和 0.013）。在 1、6 和 12 个月时，FAS 越高（疲劳越严重）与步数越低相关（P<0.001、0.01 和 0.007）、抑郁评分越高（P<0.001）、焦虑评分越高（P<0.001）、嗜睡程度越高（P<0.001）和生活质量越差（P<0.001）。1 个月时的每日步数越低（P<0.002 和 0.006）和焦虑程度越高（P<0.001）独立预测 6 个月和 12 个月时的 FAS 更高。