Prevalence and biopsychosocial predictors of post-stroke fatigue in patients with minor strokes

BACKGROUND: The majority of stroke patients suffer minor stroke. Little is known about the prevalence of post-stroke fatigue (PSF) and which factors are associated with fatigue in minor stroke patients. OBJECTIVE: To investigate the prevalence of PSF in a sample of minor stroke patients and to explore associations between biopsychosocial factors and fatigue 12 months post stroke. METHODS: In this observational study of 72 minor stroke patients fatigue symptoms were measured in the acute phase and 12 months post stroke using the Fatigue Severity Scale (FSS). At 12 months, data on psychological distress symptoms, coping strategies, balance, cognitive function, and self- report of stroke-related symptoms were collected using standardized questionnaires and tests. To explore the possible associations between fatigue and the different variables the Mann-Whitney U test and Spearman's correlations were used. A multiple regression was conducted to identify which of the factors had the strongest association with fatigue Results: Almost 20% of the sample were fatigue cases 1 year post stroke using a cut off of 5 on the FSS. PSF was strongly associated with having psychological distress symptoms. In univariate analyses, PSF was also associated with fatigue in the acute phase, stroke-related physical impairments, and self-report of symptoms of cognitive impairments. CONCLUSIONS: PSF is present in a subgroup of patients with minor stroke. To identify patients at risk of developing chronic PSF, minor stroke patients should be screened for fatigue early after stroke. A short screening of factors associated with fatigue, such as psychological distress and impaired motor, visual, or cognitive function is also advisable. There is a need for further research in larger samples on PSF and associated factors in minor stroke.