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Fatigue and pain: relationships with physical performance and patient beliefs after stroke.

Miller KK, Combs SA, Van Puymbroeck M, Altenburger PA, Kean J, Dierks TA, Schmid AA. Fatigue and pain: relationships with physical performance and patient beliefs after stroke. Topics in Stroke Rehabilitation. 2013 Jul 1; 20(4):347-55.

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BACKGROUND: Fatigue and pain are common after stroke, potentially impacting stroke recovery. OBJECTIVE: This study examines the frequency and impact of fatigue and pain in people with chronic stroke. METHOD: Seventy-seven people with chronic stroke completed a one-time assessment consisting of a battery of self-report and performance tools to describe and quantify mobility issues post stroke. We assessed the proportion of individuals with fatigue and pain and the relationship between fatigue and pain and other variables including gait (10-meter walk and 6-minute walk test), balance (Berg Balance Scale), activity and participation (ICF Measure of Participation and Activities), chronic disease self-efficacy (Chronic Disease Self-Efficacy Scale), and balance self-efficacy (Activity-Specific Balance Confidence Scale). Additionally, subgroup comparisons were made between participants with and without coexisting fatigue and pain. RESULTS: Fatigue and pain were reported by 66% and 45% of study participants, respectively. Thirty-four percent of the sample reported co-existing fatigue and pain. Participants with coexisting fatigue and pain demonstrated significantly lower chronic disease and balance self-efficacy and decreased activity than participants without coexisting fatigue and pain. Individually, fatigue correlated with balance, chronic disease self-efficacy, balance self-efficacy, activity, and participation, whereas pain correlated with chronic disease self-efficacy, balance self-efficacy, and activity. CONCLUSION: Fatigue and pain are common after stroke and are negatively correlated with outcomes important to rehabilitation. Efforts focused on examining the impact of interventions on fatigue and pain are warranted. It is possible that changes to these body structure limitations could positively impact functional recovery and community re-entry after stroke.

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