Lee Juwon, Kim Gowun
Department of Rehabilitation Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Korea.
Brain Neurorehabil. 2024 Nov 26;17(3):e22. doi: 10.12786/bn.2024.17.e22. eCollection 2024 Nov.
This study analyzed the impact of post-stroke fatigue (PSF) on functional recovery in acute and subacute stroke patients during inpatient rehabilitation. Medical records of 177 patients were retrospectively reviewed. PSF was assessed using the Fatigue Severity Scale (FSS)-9. Patients were classified into two groups: a PSF group (mean FSS ≥ 4) and a non-PSF group (mean FSS < 4). Stroke severity was measured with the National Institutes of Health Stroke Scale, and functional outcomes were evaluated using Functional Ambulation Category (FAC), Berg Balance Test, Korean version of the Modified Barthel Index (K-MBI), and Mini-Mental State Examination-Korean version (MMSE-K). Statistical significance was set at p < 0.05. The prevalence of PSF was 52.5%. The repeated measures of analysis of variance showed significant "time" effects on FAC (F = 29.726, p < 0.001) and K-MBI (F = 15.348, p < 0.001). A significant "group" effect was observed on MMSE-K (F = 4.571, p = 0.035), and a "time × group" interaction on only K-MBI (F = 4.284, p = 0.041). Multivariable logistic regression analysis showed that improvements in K-MBI scores were independent of initial severity, depression, and age (p = 0.043). PSF affects the recovery of activities of daily living (ADL) in stroke patients, suggesting that regulating early fatigue after stroke positively affects functional recovery.
本研究分析了卒中后疲劳(PSF)对急性和亚急性卒中患者住院康复期间功能恢复的影响。对177例患者的病历进行了回顾性分析。使用疲劳严重程度量表(FSS)-9评估PSF。患者分为两组:PSF组(平均FSS≥4)和非PSF组(平均FSS<4)。用美国国立卫生研究院卒中量表测量卒中严重程度,使用功能步行分类(FAC)、伯格平衡测试、韩国版改良巴氏指数(K-MBI)和韩国版简易精神状态检查表(MMSE-K)评估功能结局。设定统计学显著性为p<0.05。PSF的患病率为52.5%。重复测量方差分析显示,FAC(F=29.726,p<0.001)和K-MBI(F=15.348,p<0.001)有显著的“时间”效应。在MMSE-K上观察到显著的“组”效应(F=4.571,p=0.035),仅在K-MBI上有“时间×组”交互作用(F=4.284,p=0.041)。多变量逻辑回归分析显示,K-MBI评分的改善与初始严重程度、抑郁和年龄无关(p=0.043)。PSF影响卒中患者日常生活活动(ADL)的恢复,这表明调节卒中后的早期疲劳对功能恢复有积极影响。