Skip to main content
Top
Published in: BMC Neurology 1/2015

Open Access 01-12-2015 | Research article

Prevalence of fatigue in patients 3 months after stroke and association with early motor activity: a prospective study comparing stroke patients with a matched general population cohort

Authors: Thorlene Egerton, Anne Hokstad, Torunn Askim, Julie Bernhardt, Bent Indredavik

Published in: BMC Neurology | Issue 1/2015

Login to get access

Abstract

Background

Fatigue is a common complaint after stroke. Reasons for higher prevalence are still unclear. This study aimed to determine if fatigue prevalence in stroke patients is different to that of age and gender matched general population controls, and to explore whether early motor activity was associated with reduced likelihood of fatigue three months after stroke.

Methods

This was a prospective multicenter cohort study of stroke patients admitted to eleven regional Norwegian hospitals, within 14 days after stroke. Stroke patients (n = 257) were age and gender matched to participants in a general population health survey (HUNT3-survey) carried out in a regional county of central Norway. The single-item fatigue questionnaire from the HUNT3-survey was administered to both groups to compare prevalence. The association between early motor activity (time in bed, time sitting out of bed, and time upright) and fatigue at three months after stroke (Fatigue Severity Scale) was tested with logistic regression. Simple models including each activity outcome, with adjustment for stroke severity and pre-stroke function, were tested, as well as a comprehensive model that included additional independent variables of depression, pain, pre-stroke fatigue, age and gender.

Results

Prevalence was higher after stroke compared with the general population: 31.1 % versus 10.9 %. In the simple regression models, none of the early motor activity categories were associated with fatigue three months after stroke. In the comprehensive model, depression, pain and pre-stroke fatigue were significantly associated with post-stroke fatigue. Time in bed through the daytime during hospital stay approached statistical significance (p = 0.058) with an odds ratio for experiencing fatigue of 1.02 (95 % CI 1.00-1.04) for each additional 5.4 minutes in bed.

Conclusions

Stroke patients had higher prevalence of fatigue three months after stroke than the age and gender matched general population sample, which may be partly explained by the stroke population being in poorer health overall. The relationship between early motor activity (and inactivity) and fatigue remains unclear. Further research, which may help drive development of new treatments to target this challenging condition, is needed.
Literature
1.
go back to reference De Groot MH, Phillips SJ, Eskes GA. Fatigue associated with stroke and other neurologic conditions: implications for stroke rehabilitation. Arch Phys Med Rehabil. 2003;84:1714–20.CrossRefPubMed De Groot MH, Phillips SJ, Eskes GA. Fatigue associated with stroke and other neurologic conditions: implications for stroke rehabilitation. Arch Phys Med Rehabil. 2003;84:1714–20.CrossRefPubMed
2.
go back to reference Lerdal A, Wahl A, Rustoen T, Hanestad BR, Moum T. Fatigue in the general population: a translation and test of the psychometric properties of the Norwegian version of the fatigue severity scale. Scand J Public Health. 2005;33:123–30.CrossRefPubMed Lerdal A, Wahl A, Rustoen T, Hanestad BR, Moum T. Fatigue in the general population: a translation and test of the psychometric properties of the Norwegian version of the fatigue severity scale. Scand J Public Health. 2005;33:123–30.CrossRefPubMed
3.
go back to reference Loge JH, Ekeberg O, Kaasa S. Fatigue in the general Norwegian population: normative data and associations. J Psychosom Res. 1998;45:53–65.CrossRefPubMed Loge JH, Ekeberg O, Kaasa S. Fatigue in the general Norwegian population: normative data and associations. J Psychosom Res. 1998;45:53–65.CrossRefPubMed
4.
go back to reference Fukuda K, Dobbins JG, Wilson LJ, Dunn RA, Wilcox K, Smallwood D. An epidemiologic study of fatigue with relevance for the chronic fatigue syndrome. J Psychiatr Res. 1997;31:19–29.CrossRefPubMed Fukuda K, Dobbins JG, Wilson LJ, Dunn RA, Wilcox K, Smallwood D. An epidemiologic study of fatigue with relevance for the chronic fatigue syndrome. J Psychiatr Res. 1997;31:19–29.CrossRefPubMed
5.
go back to reference Tennant KF, Takacs SE, Gau JT, Clark BC, Russ DW. A preliminary study of symptomatic fatigue in rural older adults. Aging Clin Exp Res. 2012;24:324–30.PubMed Tennant KF, Takacs SE, Gau JT, Clark BC, Russ DW. A preliminary study of symptomatic fatigue in rural older adults. Aging Clin Exp Res. 2012;24:324–30.PubMed
6.
go back to reference Gron KL, Ornbjerg LM, Hetland ML, Aslam F, Khan NA, Jacobs JW, et al. The association of fatigue, comorbidity burden, disease activity, disability and gross domestic product in patients with rheumatoid arthritis. Results from 34 countries participating in the Quest-RA program. Clin Exp Rheumatol. 2014;32:869–77.PubMed Gron KL, Ornbjerg LM, Hetland ML, Aslam F, Khan NA, Jacobs JW, et al. The association of fatigue, comorbidity burden, disease activity, disability and gross domestic product in patients with rheumatoid arthritis. Results from 34 countries participating in the Quest-RA program. Clin Exp Rheumatol. 2014;32:869–77.PubMed
7.
go back to reference Wright F, Hammer MJ, D’Eramo Melkus G. Associations between multiple chronic conditions and cancer-related fatigue: an integrative review. Oncol Nurs Forum. 2014;41:399–410.CrossRefPubMed Wright F, Hammer MJ, D’Eramo Melkus G. Associations between multiple chronic conditions and cancer-related fatigue: an integrative review. Oncol Nurs Forum. 2014;41:399–410.CrossRefPubMed
8.
go back to reference Jason LA, Jordan KM, Richman JA, Rademaker AW, Huang CF, McCready W, et al. A community-based study of prolonged fatigue and chronic fatigue. J Health Psychol. 1999;4:9–26.CrossRefPubMed Jason LA, Jordan KM, Richman JA, Rademaker AW, Huang CF, McCready W, et al. A community-based study of prolonged fatigue and chronic fatigue. J Health Psychol. 1999;4:9–26.CrossRefPubMed
9.
go back to reference Dolan P, Kudrna L. More years, less yawns: fresh evidence on tiredness by age and other factors. J Gerontol B Psychol Sci Soc Sci. 2015;70:576–80.CrossRefPubMed Dolan P, Kudrna L. More years, less yawns: fresh evidence on tiredness by age and other factors. J Gerontol B Psychol Sci Soc Sci. 2015;70:576–80.CrossRefPubMed
10.
go back to reference Duncan F, Wu S, Mead GE. Frequency and natural history of fatigue after stroke: a systematic review of longitudinal studies. J Psychosom Res. 2012;73:18–27.CrossRefPubMed Duncan F, Wu S, Mead GE. Frequency and natural history of fatigue after stroke: a systematic review of longitudinal studies. J Psychosom Res. 2012;73:18–27.CrossRefPubMed
11.
go back to reference Lerdal A, Bakken LN, Rasmussen EF, Beiermann C, Ryen S, Pynten S, et al. Physical impairment, depressive symptoms and pre-stroke fatigue are related to fatigue in the acute phase after stroke. Disabil Rehabil. 2011;33:334–42.CrossRefPubMed Lerdal A, Bakken LN, Rasmussen EF, Beiermann C, Ryen S, Pynten S, et al. Physical impairment, depressive symptoms and pre-stroke fatigue are related to fatigue in the acute phase after stroke. Disabil Rehabil. 2011;33:334–42.CrossRefPubMed
12.
go back to reference Wang SS, Wang JJ, Wang PX, Chen R. Determinants of fatigue after first-ever ischemic stroke during acute phase. PLoS One. 2014;9. Wang SS, Wang JJ, Wang PX, Chen R. Determinants of fatigue after first-ever ischemic stroke during acute phase. PLoS One. 2014;9.
13.
go back to reference van Eijsden HM, van de Port IG, Visser-Meily JM, Kwakkel G. Poststroke fatigue: who is at risk for an increase in fatigue? Stroke research and treatment. 2012. van Eijsden HM, van de Port IG, Visser-Meily JM, Kwakkel G. Poststroke fatigue: who is at risk for an increase in fatigue? Stroke research and treatment. 2012.
14.
go back to reference Choi-Kwon S, Han SW, Kwon SU, Kim JS. Poststroke fatigue: characteristics and related factors. Cerebrovasc Dis. 2005;19:84–90.CrossRefPubMed Choi-Kwon S, Han SW, Kwon SU, Kim JS. Poststroke fatigue: characteristics and related factors. Cerebrovasc Dis. 2005;19:84–90.CrossRefPubMed
15.
go back to reference Appelros P. Prevalence and predictors of pain and fatigue after stroke: a population-based study. Int J Rehabil Res. 2006;29:329–33.CrossRefPubMed Appelros P. Prevalence and predictors of pain and fatigue after stroke: a population-based study. Int J Rehabil Res. 2006;29:329–33.CrossRefPubMed
16.
go back to reference van de Port IG, Kwakkel G, Schepers VP, Heinemans CT, Lindeman E. Is fatigue an independent factor associated with activities of daily living, instrumental activities of daily living and health-related quality of life in chronic stroke? Cerebrovasc Dis. 2007;23:40–5.CrossRefPubMed van de Port IG, Kwakkel G, Schepers VP, Heinemans CT, Lindeman E. Is fatigue an independent factor associated with activities of daily living, instrumental activities of daily living and health-related quality of life in chronic stroke? Cerebrovasc Dis. 2007;23:40–5.CrossRefPubMed
17.
go back to reference Glader EL, Stegmayr B, Asplund K. Poststroke fatigue: a 2-year follow-up study of stroke patients in Sweden. Stroke. 2002;33:1327–33.CrossRefPubMed Glader EL, Stegmayr B, Asplund K. Poststroke fatigue: a 2-year follow-up study of stroke patients in Sweden. Stroke. 2002;33:1327–33.CrossRefPubMed
18.
go back to reference Hardy S, Studenski S. Fatigue predicts mortality among older adults. J Am Geritatr Soc. 2008;56:1910–4.CrossRef Hardy S, Studenski S. Fatigue predicts mortality among older adults. J Am Geritatr Soc. 2008;56:1910–4.CrossRef
19.
20.
go back to reference Christensen D, Johnsen SP, Watt T, Harder I, Kirkevold M, Andersen G. Dimensions of post-stroke fatigue: a two-year follow-up study. Cerebrovasc Dis. 2008;26:134–41.CrossRefPubMed Christensen D, Johnsen SP, Watt T, Harder I, Kirkevold M, Andersen G. Dimensions of post-stroke fatigue: a two-year follow-up study. Cerebrovasc Dis. 2008;26:134–41.CrossRefPubMed
21.
go back to reference Kuppuswamy A, Clark EV, Turner IF, Rothwell JC, Ward NS. Post-stroke fatigue: a deficit in corticomotor excitability? Brain. 2015;138:136–48.CrossRefPubMed Kuppuswamy A, Clark EV, Turner IF, Rothwell JC, Ward NS. Post-stroke fatigue: a deficit in corticomotor excitability? Brain. 2015;138:136–48.CrossRefPubMed
22.
go back to reference Kuppuswamy A, Clark EV, Sandhu KS, Rothwell JC, Ward NS. Post-stroke fatigue: a problem of altered corticomotor control? J Neurol Neurosurg Psychiatry. 2015;86(8):902–4.CrossRefPubMed Kuppuswamy A, Clark EV, Sandhu KS, Rothwell JC, Ward NS. Post-stroke fatigue: a problem of altered corticomotor control? J Neurol Neurosurg Psychiatry. 2015;86(8):902–4.CrossRefPubMed
23.
go back to reference Michael KM, Allen JK, Macko RF. Fatigue after stroke: relationship to mobility, fitness, ambulatory activity, social support, and falls efficacy. Rehabil Nurs. 2006;31:210–7.CrossRefPubMed Michael KM, Allen JK, Macko RF. Fatigue after stroke: relationship to mobility, fitness, ambulatory activity, social support, and falls efficacy. Rehabil Nurs. 2006;31:210–7.CrossRefPubMed
24.
go back to reference Mackay-Lyons MJ, Makrides L. Exercise capacity early after stroke. Arch Phys Med Rehabil. 2002;83:1697–702.CrossRefPubMed Mackay-Lyons MJ, Makrides L. Exercise capacity early after stroke. Arch Phys Med Rehabil. 2002;83:1697–702.CrossRefPubMed
25.
go back to reference Stoquart G, Detrembleur C, Lejeune TM. The reasons why stroke patients expend so much energy to walk slowly. Gait Posture. 2012;36:409–13.CrossRefPubMed Stoquart G, Detrembleur C, Lejeune TM. The reasons why stroke patients expend so much energy to walk slowly. Gait Posture. 2012;36:409–13.CrossRefPubMed
26.
go back to reference Chen YK, Qu JF, Xiao WM, Li WY, Weng HY, Li W, et al. Poststroke fatigue: risk factors and its effect on functional status and health-related quality of life. Int J Stroke. 2014. Chen YK, Qu JF, Xiao WM, Li WY, Weng HY, Li W, et al. Poststroke fatigue: risk factors and its effect on functional status and health-related quality of life. Int J Stroke. 2014.
27.
go back to reference Choi-Kwon S, Kim JS. Poststroke fatigue: an emerging, critical issue in stroke medicine. Int J Stroke. 2011;6:328–36.CrossRefPubMed Choi-Kwon S, Kim JS. Poststroke fatigue: an emerging, critical issue in stroke medicine. Int J Stroke. 2011;6:328–36.CrossRefPubMed
28.
go back to reference Lerdal A, Bakken LN, Kouwenhoven SE, Pedersen G, Kirkevold M, Finset A, et al. Poststroke fatigue - a review. J Pain Symptom Manage. 2009;38:928–49.CrossRefPubMed Lerdal A, Bakken LN, Kouwenhoven SE, Pedersen G, Kirkevold M, Finset A, et al. Poststroke fatigue - a review. J Pain Symptom Manage. 2009;38:928–49.CrossRefPubMed
29.
go back to reference Hoang CL, Salle JY, Mandigout S, Hamonet J, Macian-Montoro F, Daviet JC. Physical factors associated with fatigue after stroke: an exploratory study. Top Stroke Rehabil. 2012;19:369–76.CrossRefPubMed Hoang CL, Salle JY, Mandigout S, Hamonet J, Macian-Montoro F, Daviet JC. Physical factors associated with fatigue after stroke: an exploratory study. Top Stroke Rehabil. 2012;19:369–76.CrossRefPubMed
30.
go back to reference Naess H, Lunde L, Brogger J, Waje-Andreassen U. Fatigue among stroke patients on long-term follow-up. The Bergen stroke study. J Neurol Sci. 2012;312:138–41.CrossRefPubMed Naess H, Lunde L, Brogger J, Waje-Andreassen U. Fatigue among stroke patients on long-term follow-up. The Bergen stroke study. J Neurol Sci. 2012;312:138–41.CrossRefPubMed
31.
go back to reference Duncan F, Lewis SJ, Greig CA, Dennis MS, Sharpe M, MacLullich AM, et al. Exploratory longitudinal cohort study of associations of fatigue after stroke. Stroke. 2015;46:1052–8.CrossRefPubMed Duncan F, Lewis SJ, Greig CA, Dennis MS, Sharpe M, MacLullich AM, et al. Exploratory longitudinal cohort study of associations of fatigue after stroke. Stroke. 2015;46:1052–8.CrossRefPubMed
32.
go back to reference Naess H, Nyland HI, Thomassen L, Aarseth J, Myhr KM. Fatigue at long-term follow-up in young adults with cerebral infarction. Cerebrovasc Dis. 2005;20:245–50.CrossRefPubMed Naess H, Nyland HI, Thomassen L, Aarseth J, Myhr KM. Fatigue at long-term follow-up in young adults with cerebral infarction. Cerebrovasc Dis. 2005;20:245–50.CrossRefPubMed
33.
go back to reference Valko PO, Bassetti CL, Bloch KE, Held U, Baumann CR. Validation of the fatigue severity scale in a Swiss cohort. Sleep. 2008;31:1601–7.PubMedCentralPubMed Valko PO, Bassetti CL, Bloch KE, Held U, Baumann CR. Validation of the fatigue severity scale in a Swiss cohort. Sleep. 2008;31:1601–7.PubMedCentralPubMed
34.
go back to reference Ponchel A, Bombois S, Bordet R, Henon H. Factors associated with poststroke fatigue: a systematic review. Stroke Res Treatment. 2015;2015:347920.CrossRef Ponchel A, Bombois S, Bordet R, Henon H. Factors associated with poststroke fatigue: a systematic review. Stroke Res Treatment. 2015;2015:347920.CrossRef
35.
go back to reference Hokstad A, Indredavik B, Bernhardt J, Ihle-Hansen H, Salvesen O, Seljeseth YM, et al. Hospital differences in motor activity early after stroke. A comparison of 11 Norwegian stroke units. J Stroke Cerebrovasc Dis. 2015. Hokstad A, Indredavik B, Bernhardt J, Ihle-Hansen H, Salvesen O, Seljeseth YM, et al. Hospital differences in motor activity early after stroke. A comparison of 11 Norwegian stroke units. J Stroke Cerebrovasc Dis. 2015.
37.
go back to reference Helvik AS, Engedal K, Krokstad S, Selbaek G. A comparison of life satisfaction in elderly medical inpatients and the elderly in a population-based study: Nord-Trondelag Health Study 3. Scandinavian J Public Health. 2011;39:337–44.CrossRef Helvik AS, Engedal K, Krokstad S, Selbaek G. A comparison of life satisfaction in elderly medical inpatients and the elderly in a population-based study: Nord-Trondelag Health Study 3. Scandinavian J Public Health. 2011;39:337–44.CrossRef
38.
go back to reference Krokstad S, Langhammer A, Hveem K, Holmen T, Midthjell K, Stene T, et al. Cohort profile: the HUNT study, Norway. Int J Epidemiol. 2013;42:968–77.CrossRefPubMed Krokstad S, Langhammer A, Hveem K, Holmen T, Midthjell K, Stene T, et al. Cohort profile: the HUNT study, Norway. Int J Epidemiol. 2013;42:968–77.CrossRefPubMed
39.
go back to reference Langhammer A, Krokstad S, Romundstad P, Heggland J, Holmen J. The HUNT study: participation is associated with survival and depends on socioeconomic status, diseases and symptoms. BMC Med Res Methodol. 2012;12:143.PubMedCentralCrossRefPubMed Langhammer A, Krokstad S, Romundstad P, Heggland J, Holmen J. The HUNT study: participation is associated with survival and depends on socioeconomic status, diseases and symptoms. BMC Med Res Methodol. 2012;12:143.PubMedCentralCrossRefPubMed
40.
go back to reference Banks JL, Marotta CA. Outcomes validity and reliability of the modified Rankin scale: implications for stroke clinical trials: a literature review and synthesis. Stroke. 2007;38:1091–6.CrossRefPubMed Banks JL, Marotta CA. Outcomes validity and reliability of the modified Rankin scale: implications for stroke clinical trials: a literature review and synthesis. Stroke. 2007;38:1091–6.CrossRefPubMed
41.
go back to reference Brott T, Adams Jr HP, Olinger CP, Marler JR, Barsan WG, Biller J, et al. Measurements of acute cerebral infarction: a clinical examination scale. Stroke. 1989;20:864–70.CrossRefPubMed Brott T, Adams Jr HP, Olinger CP, Marler JR, Barsan WG, Biller J, et al. Measurements of acute cerebral infarction: a clinical examination scale. Stroke. 1989;20:864–70.CrossRefPubMed
42.
go back to reference Bamford J, Sandercock P, Dennis M, Burn J, Warlow C. Classification and natural history of clinically identifiable subtypes of cerebral infarction. Lancet. 1991;337:1521–6.CrossRefPubMed Bamford J, Sandercock P, Dennis M, Burn J, Warlow C. Classification and natural history of clinically identifiable subtypes of cerebral infarction. Lancet. 1991;337:1521–6.CrossRefPubMed
43.
go back to reference Bernhardt J, Dewey H, Thrift A, Donnan G. Inactive and alone: physical activity within the first 14 days of acute stroke unit care. Stroke. 2004;35:1005–9.CrossRefPubMed Bernhardt J, Dewey H, Thrift A, Donnan G. Inactive and alone: physical activity within the first 14 days of acute stroke unit care. Stroke. 2004;35:1005–9.CrossRefPubMed
44.
go back to reference Naess H, Waje-Andreassen U, Thomassen L, Nyland H, Myhr KM. Health-related quality of life among young adults with ischemic stroke on long-term follow-up. Stroke. 2006;37:1232–6.CrossRefPubMed Naess H, Waje-Andreassen U, Thomassen L, Nyland H, Myhr KM. Health-related quality of life among young adults with ischemic stroke on long-term follow-up. Stroke. 2006;37:1232–6.CrossRefPubMed
45.
go back to reference Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67:361–70.CrossRefPubMed Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67:361–70.CrossRefPubMed
46.
go back to reference Krupp LB, LaRocca NG, Muir-Nash J, Steinberg AD. The fatigue severity scale. Application to patients with multiple sclerosis and systemic lupus erythematosus. Arch Neurol. 1989;46:1121–3.CrossRefPubMed Krupp LB, LaRocca NG, Muir-Nash J, Steinberg AD. The fatigue severity scale. Application to patients with multiple sclerosis and systemic lupus erythematosus. Arch Neurol. 1989;46:1121–3.CrossRefPubMed
47.
go back to reference Naess H, Nyland H. Poststroke fatigue and depression are related to mortality in young adults: a cohort study. BMJ Open. 2013;3. Naess H, Nyland H. Poststroke fatigue and depression are related to mortality in young adults: a cohort study. BMJ Open. 2013;3.
48.
go back to reference Askim T, Bernhardt J, Salvesen O, Indredavik B. Physical activity early after stroke and its association to functional outcome 3 months later. J Stroke Cerebrovasc Dis. 2014;23:e305–12.CrossRefPubMed Askim T, Bernhardt J, Salvesen O, Indredavik B. Physical activity early after stroke and its association to functional outcome 3 months later. J Stroke Cerebrovasc Dis. 2014;23:e305–12.CrossRefPubMed
49.
go back to reference Thyfault JP, Booth FW. Lack of regular physical exercise or too much inactivity. Curr Opin Clin Nutr Metab Care. 2011;14:374–8.CrossRefPubMed Thyfault JP, Booth FW. Lack of regular physical exercise or too much inactivity. Curr Opin Clin Nutr Metab Care. 2011;14:374–8.CrossRefPubMed
50.
go back to reference Allen C, Glasziou P, Del Mar C. Bed rest: a potentially harmful treatment needing more careful evaluation. Lancet. 1999;354:1229–33.CrossRefPubMed Allen C, Glasziou P, Del Mar C. Bed rest: a potentially harmful treatment needing more careful evaluation. Lancet. 1999;354:1229–33.CrossRefPubMed
51.
go back to reference Coker RH, Hays NP, Williams RH, Wolfe RR, Evans WJ. Bed rest promotes reductions in walking speed, functional parameters, and aerobic fitness in older, healthy adults. J Gerontol A Biol Sci Med Sci. 2015;70:91–6.CrossRefPubMed Coker RH, Hays NP, Williams RH, Wolfe RR, Evans WJ. Bed rest promotes reductions in walking speed, functional parameters, and aerobic fitness in older, healthy adults. J Gerontol A Biol Sci Med Sci. 2015;70:91–6.CrossRefPubMed
52.
go back to reference Egerton T, Chastin SFM, Stensvold D, Helbostad JL. Fatigue may contribute to reduced physical activity among older people: An observational study. J Gerontol A Biol Sci Med Sci 2015. In press. Egerton T, Chastin SFM, Stensvold D, Helbostad JL. Fatigue may contribute to reduced physical activity among older people: An observational study. J Gerontol A Biol Sci Med Sci 2015. In press.
53.
go back to reference Duncan F, Kutlubaev MA, Dennis MS, Greig C, Mead GE. Fatigue after stroke: a systematic review of associations with impaired physical fitness. Int J Stroke. 2012;7:157–62.CrossRefPubMed Duncan F, Kutlubaev MA, Dennis MS, Greig C, Mead GE. Fatigue after stroke: a systematic review of associations with impaired physical fitness. Int J Stroke. 2012;7:157–62.CrossRefPubMed
54.
go back to reference Govan L, Langhorne P, Weir CJ. Does the prevention of complications explain the survival benefit of organized inpatient (stroke unit) care?: further analysis of a systematic review. Stroke. 2007;38:2536–40.CrossRefPubMed Govan L, Langhorne P, Weir CJ. Does the prevention of complications explain the survival benefit of organized inpatient (stroke unit) care?: further analysis of a systematic review. Stroke. 2007;38:2536–40.CrossRefPubMed
55.
go back to reference Mead G, Bernhardt J, Kwakkel G. Stroke: physical fitness, exercise, and fatigue. Stroke Res Treatment. 2012;2012:632531.CrossRef Mead G, Bernhardt J, Kwakkel G. Stroke: physical fitness, exercise, and fatigue. Stroke Res Treatment. 2012;2012:632531.CrossRef
56.
go back to reference Zedlitz AM, Rietveld TC, Geurts AC, Fasotti L. Cognitive and graded activity training can alleviate persistent fatigue after stroke: a randomized, controlled trial. Stroke. 2012;43:1046–51.CrossRefPubMed Zedlitz AM, Rietveld TC, Geurts AC, Fasotti L. Cognitive and graded activity training can alleviate persistent fatigue after stroke: a randomized, controlled trial. Stroke. 2012;43:1046–51.CrossRefPubMed
57.
go back to reference Clarke A, Barker-Collo SL, Feigin VL. Poststroke fatigue: does group education make a difference? A randomized pilot trial. Top Stroke Rehabil. 2012;19:32–9.CrossRefPubMed Clarke A, Barker-Collo SL, Feigin VL. Poststroke fatigue: does group education make a difference? A randomized pilot trial. Top Stroke Rehabil. 2012;19:32–9.CrossRefPubMed
Metadata
Title
Prevalence of fatigue in patients 3 months after stroke and association with early motor activity: a prospective study comparing stroke patients with a matched general population cohort
Authors
Thorlene Egerton
Anne Hokstad
Torunn Askim
Julie Bernhardt
Bent Indredavik
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Neurology / Issue 1/2015
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/s12883-015-0438-6

Other articles of this Issue 1/2015

BMC Neurology 1/2015 Go to the issue