Dimensions of post-stroke fatigue: a two-year follow-up study

BACKGROUND: The aim of this study was to examine the course of poststroke fatigue in a cohort of first-time stroke patients compared to the general population, and to identify clinically relevant features of post-stroke fatigue.

METHODS: We performed a follow-up study of 165 patients with first-time stroke admitted to acute stroke units at the Aarhus University Hospital, Denmark. A reference group of 1,069 persons was sampled from the general population. Fatigue was assessed using the Multidimensional Fatigue Inventory (MFI-20) covering five scales of fatigue (General Fatigue, Physical Fatigue, Reduced Activity, Reduced Motivation, and Mental Fatigue).

RESULTS: Compared to the general population, stroke patients reported higher levels of Physical Fatigue. Minor or no differences were found for the other fatigue scales. Pathological fatigue, defined as a score >or=12 on the General Fatigue scale, was reported by 59% (95% CI: 51-66%), 44% (95% CI: 36-51%), 38% (95% CI: 31-46%), and 40% (95% CI: 32-48%) of stroke patients 10 days, 3 months, 1 year, and 2 years following hospitalization for stroke, respectively. Post-stroke fatigue levels decreased after three months and remained stable throughout the remainder of follow-up. Poor functional outcome was consistently associated with increased levels of fatigue.

CONCLUSIONS: Post-stroke fatigue is a common condition primarily characterized by increased levels of Physical Fatigue. The pathological mechanisms underlying post-stroke fatigue and its clinical implications require further study.