Functional Recovery in Acute and Subacute Stroke Patients With or Without Post-stroke Fatigue.

Brain & NeuroRehabilitation Pub Date : 2024-11-26 eCollection Date: 2024-11-01 DOI:10.12786/bn.2024.17.e22
Juwon Lee, Gowun Kim
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Abstract

This study analyzed the impact of post-stroke fatigue (PSF) on functional recovery in acute and subacute stroke patients during inpatient rehabilitation. Medical records of 177 patients were retrospectively reviewed. PSF was assessed using the Fatigue Severity Scale (FSS)-9. Patients were classified into two groups: a PSF group (mean FSS ≥ 4) and a non-PSF group (mean FSS < 4). Stroke severity was measured with the National Institutes of Health Stroke Scale, and functional outcomes were evaluated using Functional Ambulation Category (FAC), Berg Balance Test, Korean version of the Modified Barthel Index (K-MBI), and Mini-Mental State Examination-Korean version (MMSE-K). Statistical significance was set at p < 0.05. The prevalence of PSF was 52.5%. The repeated measures of analysis of variance showed significant "time" effects on FAC (F = 29.726, p < 0.001) and K-MBI (F = 15.348, p < 0.001). A significant "group" effect was observed on MMSE-K (F = 4.571, p = 0.035), and a "time × group" interaction on only K-MBI (F = 4.284, p = 0.041). Multivariable logistic regression analysis showed that improvements in K-MBI scores were independent of initial severity, depression, and age (p = 0.043). PSF affects the recovery of activities of daily living (ADL) in stroke patients, suggesting that regulating early fatigue after stroke positively affects functional recovery.

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急性和亚急性脑卒中患者卒中后疲劳的功能恢复。
本研究分析脑卒中后疲劳(PSF)对急性和亚急性脑卒中患者住院康复期间功能恢复的影响。回顾性分析177例患者的病历。使用疲劳严重程度量表(FSS)-9评估PSF。患者分为两组:PSF组(平均FSS≥4)和非PSF组(平均FSS < 4)。卒中严重程度采用美国国立卫生研究院卒中量表测量,功能结局采用功能行走分类(FAC)、Berg平衡测试、韩版修正Barthel指数(K-MBI)和韩版迷你精神状态检查(MMSE-K)评估。p < 0.05为差异有统计学意义。PSF患病率为52.5%。方差分析的重复测量显示FAC (F = 29.726, p < 0.001)和K-MBI (F = 15.348, p < 0.001)的“时间”效应显著。在MMSE-K上存在显著的“组”效应(F = 4.571, p = 0.035),而在K-MBI上存在“时间×组”相互作用(F = 4.284, p = 0.041)。多变量logistic回归分析显示,K-MBI评分的改善与初始严重程度、抑郁和年龄无关(p = 0.043)。PSF影响脑卒中患者日常生活活动(ADL)的恢复,提示脑卒中后早期调节疲劳对功能恢复有积极影响。
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