Jones Kelly, Krishnamurthi Rita, Barker-Collo Suzanne, De Silva Sulekha, Henry Nathan, Zeng Irene, Vorster Anja, Te Ao Braden, Green Geoff, Ratnasabapathy Yogini, Feigin Valery
National Institute for Stroke and Applied Neurosciences, School of Clinical Sciences Auckland University of Technology Auckland New Zealand.
School of Psychology The University of Auckland Auckland New Zealand.
J Am Heart Assoc. 2025 Jan 7;14(1):e034441. doi: 10.1161/JAHA.124.034441. Epub 2024 Dec 24.
Poststroke fatigue affects ≈50% of patients with stroke, causing significant personal, societal, and economic burden. In the FASTER (Fatigue After Stroke Educational Recovery) study, we assessed a group-based educational intervention for poststroke fatigue.
Two hundred patients with clinically significant fatigue were included and randomized to either a general stroke education control or fatigue management group (FMG) intervention and assessed at baseline, 6 weeks, and 3 months. The FMG involved weekly psychoeducation sessions over 6 weeks. Coprimary outcomes were the Fatigue Severity Scale and Multidimensional Fatigue Inventory-20 total scores. Adjusted mean total Fatigue Severity Scale scores at 6 weeks (primary end point) were nearly identical for the education control and FMG groups. The adjusted mean difference between treatment groups was -0.13 (SE, 1.4; =0.92) at 6 weeks and 1.67 (SE, 1.4; =0.26) at 3 months. Although there were no significant effects, Fatigue Severity Scale outcomes were in the direction of a treatment effect based on the estimated change. Adjusted mean total Multidimensional Fatigue Inventory-20 scores at 6 weeks (primary end point) were similar for the education control and FMG groups. The adjusted mean difference between treatment groups was -0.91 (SE, 1.54; =0.55) at 6 weeks and -1.26 (SE, 1.8; =0.49) at 3 months. Both groups had similar secondary outcomes (eg, Multidimensional Fatigue Inventory-20 subscales, sleep, pain, mood, quality of life) at 6 weeks and 3 months.
We found no evidence of significant group-level benefits of FMG over and above general stroke education. Educational group-based interventions for poststroke fatigue should continue to be refined and examined, including consideration of potential impacts at an individual level.
URL: https://www.anzctr.org.au/; UnIque identifier: ACTRN12619000626167.
中风后疲劳影响约50%的中风患者，造成重大的个人、社会和经济负担。在FASTER（中风后疲劳教育康复）研究中，我们评估了一种针对中风后疲劳的基于小组的教育干预措施。
纳入200例有临床显著疲劳的患者，随机分为一般中风教育对照组或疲劳管理组（FMG）干预组，并在基线、6周和3个月时进行评估。FMG包括在6周内每周进行一次心理教育课程。共同主要结局是疲劳严重程度量表和多维疲劳量表-20总分。在6周（主要终点）时，教育对照组和FMG组的调整后平均疲劳严重程度量表总分几乎相同。治疗组之间在6周时的调整后平均差异为-0.13（标准误，1.4；P = 0.92），在3个月时为1.67（标准误，1.4；P = 0.26）。虽然没有显著效果，但根据估计的变化，疲劳严重程度量表的结局显示出治疗效果的趋势。在6周（主要终点）时，教育对照组和FMG组的调整后平均多维疲劳量表-20总分相似。治疗组之间在6周时的调整后平均差异为-0.91（标准误, 1.54；P = 0.55），在3个月时为-1.26（标准误, 1.8；P = 0.49）。两组在6周和3个月时的次要结局（如多维疲劳量表-20子量表、睡眠、疼痛、情绪、生活质量）相似。
我们没有发现证据表明FMG比一般中风教育有显著的组水平益处。基于小组的中风后疲劳教育干预措施应继续完善和研究，包括考虑个体层面的潜在影响。
