A systematic review of post-stroke fatigue measurement scale based on COSMIN guidelines

We've known of post stroke fatigue a long time. WHY THE FUCK AREN'T YOU SOLVING IT?

This did absolutely nothing to help survivors recover. I'd fire the mentors and senior researchers involved!  A lot of dead wood needs to be removed in stroke so we can actually get around to solving stroke to 100% recovery!

At least half of all stroke survivors experience fatigue Known since March 2017

Or is it 70%? Known since March 2015.

Or is it 40%? Known since September 2017.

A systematic review of post-stroke fatigue measurement scale based on COSMIN guidelines

Lingsha Wu^*Haiqin Jin

• The Second Hospital of Jiaxing, Jiaxing, China

Objective: This study aimed to evaluate the methodological quality and measurement attribute quality of the post-stroke fatigue measurement scale, so as to provide some basis for the clinical application and promotion of related scales.

Methods: The Chinese National Knowledge Infrastructure, the Wanfang Data Knowledge Service Platform, the China Science and Technology Journal Database, the Chinese Medical Journal Full-text Database, the Chinese Biology Medicine, PubMed, Embase, Medline, the Cochrane Library, the Web of Science, CINAHL, and PsycINFO databases were searched for literature on the post-stroke fatigue measurement scale up to June 2022. Literature screening and data extraction were carried out independently by two researchers, and in the case of disagreement, discussions were held with a third investigator to reach an agreement, and the COSMIN checklist and criteria were used to systematically evaluate the attributes of the measurement scale.

Results: A total of 17 studies were included, involving 10 post-stroke fatigue measurement scales. The content validity of FSS-7, FACIT-F, NRS-FRS, and MFI-20 was “not mentioned,” and the remaining scales were “uncertain.” In terms of construct validity, MFS was “adequate”; FSS-7, FACIT-F, and NRS-FRS were “not mentioned”; and the remaining scales were “uncertain.” In terms of internal consistency, NRS-FRS was “not mentioned”; FSS and MFS were “adequate”; and the remaining scales were “uncertain.” In terms of hypothesis testing, CIS and FACIT-F were “not mentioned,” NRS-FRS was “adequate,” and the remaining scales were “uncertain.” The stability of FSS-7, CIS, FACIT-F, and MFI-20 was “not mentioned,” and the remaining scales were “adequate.” The cross-cultural validity of FSS-7 was “adequate,” and the remaining scales were “not mentioned.” All 10 scales were given a recommendation grade of “B”.

Conclusion: For the time being, the FSS can be recommended to measure post-stroke fatigue, but it still needs to be tested for more relevant measurement properties in order to gain more support from high-quality evidence. For a more comprehensive assessment of post-stroke fatigue, the FIS, FAS, and NFI-stroke should perhaps be considered, as the FSS is a one-dimensional scale that can only measure physical fatigue in patients; however, these scales also need to be tested for more relevant measurement properties to verify their clinical applicability.

1 Introduction

Post-stroke fatigue is not related to tension and is a subjective feeling of stroke survivors about weakness and tiredness (1, 2). PSF arises not only from physical activities but also from mental or social activities. As one of the common complications after stroke, it has a high incidence, which will make it difficult or impossible for patients to maintain daily activities, thus causing a certain degree of adverse effects on their quality of life (3, 4). Accurate measurement of PSF is the premise and basis for the timely and effective treatment of the disease. There are many scales used to measure PSF, such as the fatigue severity scale (FSS) (5), fatigue impact scale (FIS) (6), and fatigue assessment scale (FAS) (7). Kjeverud et al. (8) explored the frequency and overlap of PSF by using scales, such as FSS, and the results showed that different scales produced different results. Blackwell et al. (9) noted that there are currently no corresponding guidelines to assess fatigue management in patients with PSF in fatigue management and that there are no established guidelines yet. Thus it can be seen different measurement focus of different scales, it has not been able to determine whether these scales have good measurement properties, and few studies to systematically evaluate these measurement properties. The guidelines for the selection criteria for health measurement tools (COSMIN) (10) can assess the methodological quality and measurement attribute quality of the scale, and the best scale for the purpose of the study can be selected. In this study, a systematic evaluation of PSF measurement scales using COSMIN quality standards was carried out to clarify the methodological quality and measurement attribute quality of relevant scales. It aimed to comprehensively evaluate the evidence level of each measurement attribute, leading to the final recommendation and providing certain evidence-based support for the application and promotion of relevant scales in clinical practice.