Usman Jibrin S, Wong Thomson W L, Ng Shamay S M
Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China.
Front Neurol. 2024 Oct 8;15:1420443. doi: 10.3389/fneur.2024.1420443. eCollection 2024.
Effective post-stroke mobility, recovery, performance, and participation are key goals for stroke survivors. However, these outcomes may be hindered by post-stroke fatigue (PSF), which can affect numerous aspects of post-stroke mobility, recovery, performance, functioning, community participation, and return to work. This review aimed to assess the scientific evidence on the relationship between PSF and mobility function, functional recovery, functional performance, and participation-related outcomes among stroke survivors.
A comprehensive search of Cochrane Central, PubMed, Embase, and Web of Science (WoS) databases was conducted from inception to December 2023. Observational, cross-sectional, and longitudinal studies were included. The methodological quality of the included studies was assessed using the National Institute of Health's quality assessment tool, while the risk of bias was assessed using the Quality in Prognostic Studies tool. A total of 28 studies (n = 2,495 participants, 1,626 men, mean age ranging from 52.5 ± 9.5 to 71.1 ± 9.9 years) were included. The data analysis was conducted using narrative and quantitative synthesis. Fixed and random effects meta-analyses were conducted to explore the relationships between PSF and relevant outcomes.
Chronic PSF was found to have significant negative correlations with mobility (meta r = -0.106, < 0.001), balance performance (meta r = -0.172; 95%; = 0.004), and quality of life (meta r = -0.647; < 0.001). It also showed significant positive correlations with stroke impairment (meta r = 0.144, < 0.001) and disability (meta r = 0.480, < 0.001). Additionally, exertion/acute PSF had significantly negative correlations with walking economy (meta r = -0.627, < 0.001) and walking endurance (meta r = -0.421, = 0.022). The certainty of evidence was deemed moderate for these relationships.
Our findings indicate that higher levels of PSF are associated with poorer mobility, balance, and participation, as well as greater disability and stroke impairment. Future studies, especially prospective longitudinal and randomized controlled trials, are warranted to substantiate our findings.
PROSPERO, identifier: CRD42023492045.
有效的中风后活动能力、恢复情况、表现和参与度是中风幸存者的关键目标。然而，这些结果可能会受到中风后疲劳（PSF）的阻碍，PSF会影响中风后活动能力、恢复情况、表现、功能、社区参与度以及重返工作岗位等诸多方面。本综述旨在评估关于中风幸存者中PSF与活动功能、功能恢复、功能表现以及参与相关结果之间关系的科学证据。
对Cochrane Central、PubMed、Embase和科学网（WoS）数据库进行了从建库至2023年12月的全面检索。纳入观察性、横断面和纵向研究。使用美国国立卫生研究院的质量评估工具评估纳入研究的方法学质量，同时使用预后研究质量工具评估偏倚风险。共纳入28项研究（n = 2495名参与者，1626名男性，平均年龄在52.5±9.5岁至71.1±9.9岁之间）。采用叙述性和定量综合分析进行数据分析。进行固定效应和随机效应荟萃分析以探讨PSF与相关结果之间的关系。
发现慢性PSF与活动能力（荟萃分析r = -0.106，P < 0.001）、平衡能力（荟萃分析r = -0.172；95%CI；P = 0.004）和生活质量（荟萃分析r = -0.647；P < 0.001）存在显著负相关。它还与中风损伤（荟萃分析r = 0.144，P < 0.001）和残疾（荟萃分析r = 0.480，P < 0.001）存在显著正相关。此外，用力/急性PSF与步行经济性（荟萃分析r = -0.627，P < 0.001）和步行耐力（荟萃分析r = -0.421，P = 0.022）存在显著负相关。这些关系的证据确定性被认为是中等的。
我们的研究结果表明，较高水平的PSF与较差的活动能力、平衡能力和参与度相关，同时也与更大程度的残疾和中风损伤相关。未来的研究，尤其是前瞻性纵向研究和随机对照试验，有必要证实我们的研究结果。
PROSPERO，标识符：CRD42023492045。
