Post-stroke fatigue: a scoping review

Ghazaleh Aali; Avril Drummond; Roshan das Nair; Farhad Shokraneh

doi:10.12688/f1000research.22880.2

Post-stroke fatigue: a scoping review

F1000Res. 2020 Apr 7:9:242. doi: 10.12688/f1000research.22880.2. eCollection 2020.

Authors

Ghazaleh Aali^{1

2}, Avril Drummond³, Roshan das Nair^{1

2}, Farhad Shokraneh^{1

2

4}

Affiliations

¹ Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK.
² Institute of Mental Health, Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK.
³ Faculty of Medicine and Health Sciences, School of Health Sciences, Queen's Medical Centre, University of Nottingham, Nottingham, UK.
⁴ King's Technology Evaluation Centre (KiTEC), London Institute of Healthcare Engineering, School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.

Abstract

Background: Post-stroke fatigue (PSF) is one of the most common and frustrating outcomes of stroke. It has a high prevalence and it can persist for many years after stroke. PSF itself contributes to a wider range of undesirable outcomes that affect all aspects of daily life. The aim of this review was to identify and summarise the most recent research on PSF, in order to update the evidence base. Methods: We updated an existing review (Hinkle et al. 2017) systematically searching CINAHL, MEDLINE, PsycINFO, and PubMed to cover new research studies between 1 ^st March 2016 and the search date (19 ^th January 2020). We included interventional and observational research, and clinical practice guidelines that were not covered in the original review. After duplicate removal in EndNote, two reviewers screened the search results in Rayyan, and data from eligible full texts were extracted onto an Excel spreadsheet. Finally, we used RobotReviewer and a human reviewer to assess the risk of bias of randomised trials for this scoping review. Results: We identified 45 records for 30 studies (14 observational, 10 interventional studies, and 6 guidelines). Apart from one, the interventional studies were single-centred, had high risk of bias and small sample size (median 50). They investigated exercise, pharmacotherapy, psychotherapy, education, and light therapy. Observational studies mainly reported the factors related to PSF including co-morbidities, depression and anxiety, quality of life, activities of daily living, stroke severity, medication use and polypharmacy, polymorphism, pain, apathy, limb heaviness, neuroticism, mobility, and thyroid-stimulating hormone. Guidelines either did not report on PSF or, when reported, their recommendations were supported by little or low level of evidence. Conclusion: Although we identified a number of recent studies which have added to our current knowledge on PSF, none are robust enough to change current clinical practice.

Keywords: Post-Stroke Fatigue; Scoping Review.

Publication types

Research Support, Non-U.S. Gov't
Systematic Review

MeSH terms

Activities of Daily Living
Cross-Sectional Studies
Fatigue / etiology*
Fatigue / therapy
Humans
Observational Studies as Topic
Quality of Life*
Stroke / complications*

Grants and funding

Drummond A, Thomas S, Jones F, dasNair R, Sprigg N, Jones A. Nottingham Fatigue Study-Developing a Fatigue Programme: NotFAST2. Stroke Association. Research ID: SA PG 19\100060; 20 Months (1st Dec 2019 – 31st July 2021). URL: https://www.stroke.org.uk/research/notfast2-nottingham-fatigue-study-developing-fatigue-intervention This scoping review reports independent research funded by the UK Stroke Association. The views expressed are those of the author(s) and not necessarily those of the UK Stroke Association.