Abstract
Objective
To advance our understanding of poststroke fatigue by investigating its momentary
and time-lagged relationship with daily activities.
Design
Longitudinal observational study using the experience sampling method (ESM).
Setting
Outpatient rehabilitation care.
Participants
Thirty individuals with stroke (N=30).
Interventions
Not applicable.
Main Outcome Measures
ESM is a structured diary method that allows assessing real-time symptoms, behavior,
and environment characteristics in the flow of daily life, thereby capturing moment-to-moment
variations in fatigue and related factors. Using a mobile application, individuals
with stroke were followed during 6 consecutive days, and were prompted at 10 random
moments daily to fill in a digital questionnaire about their momentary fatigue and
current activity: type of activity, perceived effort and enjoyment, and physical activity
levels.
Results
Based on all completed digital questionnaires (N=1013), multilevel regression analyses showed that fatigue was significantly associated
with type of activity and that fatigue was higher when participants had engaged in
physical activity. Fatigue was also higher during activities perceived as more effortful
and during less enjoyable activities. Time-lagged analyses showed that fatigue was
also predicted by physical activity and perceived effort earlier during the day. Importantly,
the relationship between these daily activity characteristics and fatigue differed
substantially across individuals.
Conclusions
This study illustrates the need for ESM to design personalized rehabilitation programs
and to capture fatigue and other patient-reported outcomes in daily life.
Keywords
List of abbreviations:
ESM (experience sampling method), FSS (Fatigue Severity Scale), HADS (Hospital Depression Anxiety Scale), PSF (poststroke fatigue)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: January 27, 2020
Footnotes
Disclosures: none.
Identification
Copyright
© 2020 by the American Congress of Rehabilitation Medicine
