Poststroke fatigue in subacute and chronic stroke rehabilitation phase: prevalence, associated factors and impact on self-efficacy and functional ability

 Prevalence has been known for over a decade. WHY THE FUCK AREN'T YOU CURING FATIGUE? This did nothing useful, you're all fired!

At least half of all stroke survivors experience fatigue Or is it 70%?

Or is it 40%?

Poststroke fatigue in subacute and chronic stroke rehabilitation phase: prevalence, associated factors and impact on self-efficacy and functional ability

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Abstract

 Background Stroke is a leading cause of death and long-term disability worldwide, with low-income and middle-income countries accounting for about 87% of stroke-related deaths and disability-adjusted life-years. Among poststroke complications, poststroke fatigue is a common but often under-recognised condition characterised by emotional, cognitive and physical exhaustion unrelated to exertion and not relieved by rest. Poststroke fatigue can hinder functional recovery, yet it remains underassessed in the study area. So this study investigates the prevalence, associated factors and impact of poststroke fatigue on self-efficacy and activities of daily living.

Methods A hospital-based cross-sectional study was conducted through a systematic random sampling technique on 370 study participants. The Fatigue Severity Scale, Nottingham Extended Activities of Daily Living and Stroke Self-efficacy Questionnaire were used to collect questionnaires related to fatigue and its impact. The data were analysed on SPSS using binary logistic regression to assess associated factors and ordinal logistic regression to assess impacts of fatigue on self-efficacy and activities of daily living.

Result Fatigue was reported by 65.4% of participants (95% CI 60.30% to 70.20%) during the subacute and chronic rehabilitation phases. Older age, both overweight and underweight body mass index, National Institutes of Health Stroke Scale ≥12, lacked physiotherapy follow-up and experiencing depression were associated with poststroke fatigue with 95% CI and p<0.05. Moreover, individuals with poststroke fatigue were approximately 5.4 times less likely to report higher functional levels and 3.6 times less likely to demonstrate greater self-efficacy compared with those without fatigue.

Conclusions Poststroke fatigue is highly prevalent among stroke survivors and negatively impacts both self-efficacy and functional ability. These findings highlight the need for early identification and targeted management of fatigue to improve rehabilitation outcomes and quality of life in stroke survivors.

What is already known on this topic

• Poststroke fatigue is a common and disabling consequence of stroke, often persisting into the subacute and chronic phases of recovery.

What this study adds

• Importantly, the study quantifies the impact of fatigue in the study setting and our country, demonstrating that individuals without fatigue are substantially more likely to achieve better functional outcomes and self-efficacy. These findings provide a more comprehensive understanding by assessing prevalence, factors and impact of stroke survivors in low-resource hospital settings.

How this study might affect research, practice or policy

• This study is the first of its kind in our country to comprehensively assess the poststroke fatigue and its functional and psychological impacts. Therefore, the study underscores the importance of strengthening poststroke care infrastructure, including accessible rehabilitation services and mental health support, particularly in resource-limited settings.