Is Fatigue After Stroke Associated With Physical Deconditioning? A Cross-Sectional Study in Ambulatory Stroke Survivors

Abstract Lewis SJ, Barugh AJ, Greig CA, Saunders DH, Fitzsimons C, Dinan-Young S, Young A, Mead GE. Is fatigue after stroke associated with physical deconditioning? A cross-sectional study in ambulatory stroke survivors. Objective To determine the relationship between a measure of fatigue and 2 indices of physical fitness, lower limb extensor power (LLEP) and walking economy. Design This was a cross-sectional study of patients with stroke. Fatigue was assessed by vitality (VIT) score of the Medical Outcomes Study 36-Item Short-Form Health Survey version 2 (SF-36v2). LLEP of the unaffected limb was measured using a lower leg extensor power rig. Walking economy was calculated by measuring oxygen consumption (mL·kg–1 ·m–1 ) during walking at a comfortable speed. Bivariate analyses were performed relating VIT to indices of fitness. Multiple regression analyses were also performed and included age, sex, and either SF-36v2 emotional role function or SF-36v2 mental health, as predictors of VIT. Setting Community setting. Participants Participants (N=66; 36 men; mean age ± SD, 71.0±9.9y) were all community dwelling, had survived a stroke, were able to walk independently, and had completed their stroke rehabilitation. Interventions Not applicable Main Outcome Measures The main outcome measure is SF-36v2 (VIT), with walking economy and LLEP of the limb unaffected by the stroke being independent variables. Results Walking economy was not significantly related to VIT ( R =–.024, P =.86, n=60). LLEP was positively related to VIT in bivariate analysis ( R =.38, P =.003, n=58). After controlling for age, sex, and SF-36 emotional role function (or SF-36v2 mental health if the extreme outlier was excluded), LLEP remained a significant predictor of VIT. Conclusions We found an association between fatigue and reduced LLEP. If a larger study confirms these findings, it would support the need to develop and test interventions to increase LLEP as a treatment for fatigue after stroke.