Juárez-Belaúnde Alan, Soto-León Vanesa, Dileone Michele, Orcajo Elena, León-Álvarez Natacha, Muñoz Alberto, Tornero Jesus, Oliviero Antonio
Advanced Neurorehabilitation Unit, Hospital Los Madroños, Madrid, Spain.
FENNSI Group, Hospital Nacional de Parapléjicos, SESCAM, Toledo, Spain.
Front Neurol. 2024 Jun 11;15:1364446. doi: 10.3389/fneur.2024.1364446. eCollection 2024.
Poststroke fatigue is a prevalent issue among stroke survivors, significantly impeding functional recovery and diminishing their quality of life.
This prospective cohort study aims to investigate the association between poststroke fatigue and the extent of functional recovery in survivors of ischemic and hemorrhagic strokes. Additionally, it seeks to delineate the temporal progression of poststroke fatigue in these two stroke subtypes.
We assessed a cohort of 79 patients recovering from acute ischemic or hemorrhagic strokes. Poststroke fatigue was quantified using the Fatigue Severity Scale (FSS) and the Numeric Rating Scale (NRS). Patients' condition was evaluated using the National Institute of Health Stroke Scale (NIHSS), and functional independence levels were determined using the Barthel Index for Activities of Daily Living (BIADL) and the Modified Rankin Scale (MRS). Depressive mood and pain were measured using the Beck Depression Inventory (BDI) and the Numeric Rating Scale for pain (NRSpain), respectively.
Our primary findings indicate that the early manifestation of clinically significant fatigue (CSF) is predictive of a poorer trajectory in functional independence levels during recovery. Furthermore, we observed differing patterns of fatigue progression between ischemic and hemorrhagic strokes. Fatigue tends to ameliorate over time in hemorrhagic stroke cases, paralleling functional recovery, while it remains stable over time in ischemic stroke cases.
Our results underscore the detrimental impact of early poststroke fatigue on long-term outcomes. Furthermore, they highlight the imperative of managing poststroke fatigue, particularly during the subacute phase of stroke recovery.
中风后疲劳是中风幸存者中普遍存在的问题，严重阻碍功能恢复并降低他们的生活质量。
这项前瞻性队列研究旨在调查缺血性和出血性中风幸存者中风后疲劳与功能恢复程度之间的关联。此外，它还试图描绘这两种中风亚型中风后疲劳的时间进展情况。
我们评估了一组79名从急性缺血性或出血性中风中恢复的患者。使用疲劳严重程度量表（FSS）和数字评定量表（NRS）对中风后疲劳进行量化。使用美国国立卫生研究院卒中量表（NIHSS）评估患者的病情，并使用日常生活活动巴氏指数（BIADL）和改良Rankin量表（MRS）确定功能独立水平。分别使用贝克抑郁量表（BDI）和疼痛数字评定量表（NRSpain）测量抑郁情绪和疼痛。
我们的主要研究结果表明，临床上显著疲劳（CSF）的早期表现预示着恢复期间功能独立水平的较差轨迹。此外，我们观察到缺血性和出血性中风之间疲劳进展的不同模式。在出血性中风病例中，疲劳往往会随着时间的推移而改善，与功能恢复并行，而在缺血性中风病例中，疲劳随时间保持稳定。
我们的结果强调了中风后早期疲劳对长期预后的有害影响。此外，它们突出了管理中风后疲劳的必要性，特别是在中风恢复的亚急性期。
