Fatigue in men and women who have returned to work after stroke: Assessed with the fatigue severity scale and mental fatigue scale

Authors

  • Anna Norlander Department of Health Sciences, Lund University, Lund, Sweden
  • Ingrid Lindgren
  • Hélène Pessah-Rasmussen
  • Gunvor Gard
  • Christina Brogårdh

DOI:

https://doi.org/10.2340/16501977-2863

Keywords:

cerebral stroke, data correlation, disability evaluation, mental fatigue, return to work, self-assessment, stroke rehabilitation

Abstract

Objective: To assess the occurrence of self-reported fatigue among men and women who have returned to work after stroke, and the association between 2 fatigue rating scales.

Design: A cross-sectional study.

Subjects: A total of 91 adults (58 men/33 women, mean age 53 years) with mild to moderate disability.

Methods: Questionnaires were posted to participants approximately one year after stroke. Fatigue was assessed with the Fatigue Severity Scale (FSS) and the Mental Fatigue Scale (MFS).

Results: In total, 58% of the women and 33% of the men reported fatigue on the FSS (total score ≥ 4), and 46% of the women and 28% of the men reported mental fatigue on the MFS (total score ≥ 10.5). Being easily fatigued, decreased motivation, mental fatigability and sensitivity to stress were the most reported problems. FSS and MFS were moderately associated (rho 0.517–0.732).

Conclusion: Fatigue is common among persons who have returned to work after stroke, and interferes with daily life. The long-term consequences of fatigue should be addressed after stroke, especially in women. The FSS and the MFS can be used in combination, as they provide information on different aspects of fatigue.

Key words: cerebral stroke; data correlation; disability evaluation; mental fatigue; return to work; self-assessment; stroke rehabilitation.

Lay abstract

Fatigue can be a long-lasting and disabling impairment following stroke. There is a need for increased knowledge of how fatigue affects people who have returned to work after stroke, and which fatigue rating scales capture their problems most appropriately. The aim of this study was to assess the occurrence of self-reported fatigue among men and women who have returned to work after stroke, and to determine the association between 2 fatigue rating scales. The study was based on a postal survey and includes 91 participants. Fatigue was found to be common 1 year after stroke, especially in women, and interfered with daily life. The 2 fatigue rating scales could be used in combination, as they provide different information on fatigue. The findings could be used to develop support that enables people with stroke to return to and to stay at work long-term.

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References

Feigin VL, Norrving B, Mensah GA. Global burden of stroke. Circ Res 2017; 120: 439–448.

Adamson J, Beswick A, Ebrahim S. Is stroke the most common cause of disability? J Stroke Cerebrovasc Dis 2004; 13: 171–177.

Socialstyrelsen. Statistikdatabas för stroke. 2019 [updated 2020 Dec 02; cited 2021 Jan 14]. Available from: https://sdb.socialstyrelsen.se/if_stroke/val.aspx.

Rosengren A, Giang KW, Lappas G, Jern C, Toren K, Bjorck L. Twenty-four-year trends in the incidence of ischemic stroke in Sweden from 1987 to 2010. Stroke 2013; 44: 2388–2393.

Alguren B, Lundgren-Nilsson A, Sunnerhagen KS. Functioning of stroke survivors--A validation of the ICF core set for stroke in Sweden. Disabil Rehabil 2010; 32: 551–559.

Paanalahti M, Berzina G, Lundgren-Nilsson A, Arndt T, Sunnerhagen KS. Examination of the relevance of the ICF cores set for stroke by comparing with the Stroke Impact Scale. Disabil Rehabil 2019; 41: 508–513.

Crosby GA, Munshi S, Karat AS, Worthington E, Lincoln NB. Fatigue after stroke: frequency and effect on daily life. Disabil Rehabil 2012; 34: 633–637.

White JH, Gray KR, Magin P, Attia J, Sturm J, Carter G, et al. Exploring the experience of post-stroke fatigue in community dwelling stroke survivors: a prospective qualitative study. Disabil Rehabil 2012; 34: 1376–1384.

Cumming TB, Packer M, Kramer SF, English C. The prevalence of fatigue after stroke: a systematic review and meta-analysis. Int J Stroke 2016; 11: 968–977.

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: 1232–1236.

Tang WK, Lu JY, Chen YK, Mok VC, Ungvari GS, Wong KS. Is fatigue associated with short-term health-related quality of life in stroke? Arch Phys Med Rehabil 2010; 91: 1511–1515.

Glader EL, Stegmayr B, Asplund K. Poststroke fatigue: a 2-year follow-up study of stroke patients in Sweden. Stroke 2002; 33: 1327–1333.

Mead GE, Graham C, Dorman P, Bruins SK, Lewis SC, Dennis MS, et al. Fatigue after stroke: baseline predictors and influence on survival. Analysis of data from UK patients recruited in the International Stroke Trial. PLoS One 2011; 6: e16988.

Palm S, Rönnbäck L, Johansson B. Long-term mental fatigue after traumatic brain injury and impact on employment status. J Rehabil Med 2017; 49: 228–233.

Carlsson GE, Möller A, Blomstrand C. Consequences of mild stroke in persons <75 years – a 1-year follow-up. Cerebrovasc Dis 2003; 16: 383–388.

Terrill AL, Schwartz JK, Belagaje SR. Best practices for the interdisciplinary rehabilitation team: a review of mental health issues in mild stroke survivors. Stroke Res Treat 2018; 2018: 6187328.

Andersen G, Christensen D, Kirkevold M, Johnsen SP. Post-stroke fatigue and return to work: a 2-year follow-up. Acta Neurol Scand 2012; 125: 248–253.

Palstam A, Törnbom M, Sunnerhagen KS. Experiences of returning to work and maintaining work 7 to 8 years after a stroke: a qualitative interview study in Sweden. BMJ Open 2018; 8: e021182.

Lindgren I, Brogårdh C, Pessah-Rasmussen H, Jonasson SB, Gard G. Work conditions, support, and changing personal priorities are perceived important for return to work and for stay at work after stroke - a qualitative study. Disabil Rehabil 2020; 26: 1–7. [Epub ahead of print].

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: 1121–1123.

Johansson B, Rönnbäck L. Mental fatigue and cognitive impairment after an almost neurological recovered stroke. ISRN Psychiatry 2012; 2012: 686425.

Johansson B, Starmark A, Berglund P, Rödholm M, Rönnbäck L. A self-assessment questionnaire for mental fatigue and related symptoms after neurological disorders and injuries. Brain Inj 2010; 24: 2–12.

Duncan P, Bode R. Min Lai S, Perera S; Glycine Antagonist in Neuroprotection Americans Investigators. Rasch analysis of a new stroke-specific outcome scale: the Stroke Impact Scale. Arch Phys Med Rehabil 2003; 84: 950–963.

Mattsson M, Möller B, Lundberg I, Gard G, Boström C. Reliability and validity of the Fatigue Severity Scale in Swedish for patients with systemic lupus erythematosus. Scand J Rheumatol 2008; 37: 269–277.

Lexell J, Jonasson SB, Brogårdh C. Psychometric properties of three fatigue rating scales in individuals with late effects of polio. Ann Rehabil Med 2018; 42: 702–712.

Valko PO, Bassetti CL, Bloch KE, Held U, Baumann CR. Validation of the Fatigue Severity Scale in a Swiss cohort. Sleep 2008; 31: 1601–1607.

Schepers VP, Visser-Meily AM, Ketelaar M, Lindeman E. Poststroke fatigue: course and its relation to personal and stroke-related factors. Arch Phys Med Rehabil 2006; 87: 184–188.

Johansson B, Rönnbäck L. Evaluation of the Mental Fatigue Scale and its relation to cognitive and emotional functioning after traumatic brain injury or stroke. Int J Phys Med Rehabil 2014; 2: 1–7.

Mukaka MM. Statistics corner: a guide to appropriate use of correlation coefficient in medical research. Malawi Med J 2012; 24: 69–71.

Flinn NA, Stube JE. Post-stroke fatigue: qualitative study of three focus groups. Occup Ther Int 2010; 17: 81–91.

Carlsson G, Möller A, Blomstrand C. A qualitative study of the consequences of ‘hidden dysfunctions’ one year after a mild stroke in persons <75 years. Disabil Rehabil 2009; 26: 1373–1380.

Moran GM, Fletcher B, Feltham MG, Calvert M, Sackley C, Marshall T. Fatigue, psychological and cognitive impairment following transient ischaemic attack and minor stroke: a systematic review. Eur J Neurol 2014; 21: 1258–1267.

Brouwer R, Wondergem R, Otten C, Pisters MF. Effect of aerobic training on vascular and metabolic risk factors for recurrent stroke: a meta-analysis. Disabil Rehabil 2019: 1–8.

Bonner NS, O’Halloran PD, Bernhardt J, Cumming TB. Developing the Stroke Exercise Preference Inventory (SEPI). PLoS One 2016; 11: e0164120.

Chen K, Marsh EB. Chronic post-stroke fatigue: it may no longer be about the stroke itself. Clin Neurol Neurosurg 2018; 174: 192–197.

Mead G, Lynch J, Greig C, Young A, Lewis S, Sharpe M. Evaluation of fatigue scales in stroke patients. Stroke 2007; 38: 2090–2095.

Lerdal A, Kottorp A. Psychometric properties of the Fatigue Severity Scale-Rasch analyses of individual responses in a Norwegian stroke cohort. Int J Nurs Stud 2011; 48: 1258–1265.

Faux SG, Arora P, Shiner CT, Thompson-Butel AG, Klein LA. Rehabilitation and education are underutilized for mild stroke and TIA sufferers. Disabil Rehabil 2018; 40: 1480–1484.

Norlander A, Iwarsson S, Jönsson AC, Lindgren A, Månsson Lexell E. Living and ageing with stroke: an exploration of conditions influencing participation in social and leisure activities over 15 years. Brain Inj 2018; 32: 858–866.

Radman N, Staub F, Aboulafia-Brakha T, Berney A, Bogousslavsky J, Annoni JM. Poststroke fatigue following minor infarcts: a prospective study. Neurology 2012; 79: 1422–1427.

Ezekiel L, Field L, Collet J, Dawes H, Boulton M. Experiences of fatigue in daily life of people with acquired brain injury: a qualitative study. Disabil Rehabil 2020: 1–9. [Epub ahaed of print].

Published

2021-09-09

How to Cite

Norlander, A., Lindgren, I., Pessah-Rasmussen, H. ., Gard, G., & Brogårdh, C. (2021). Fatigue in men and women who have returned to work after stroke: Assessed with the fatigue severity scale and mental fatigue scale. Journal of Rehabilitation Medicine, 53(9), jrm00227. https://doi.org/10.2340/16501977-2863

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