RehabMove 2018: UNRAVELLING FATIGUE AND ACTIVITY PACING IN MAINTAINING A PHYSICALLY ACTIVE LIFESTYLE AFTER STROKE REHABILITATION

PURPOSES: 1) To identify fatigue trajectories after stroke rehabilitation, 2) to determine which factors are associated with trajectory membership before discharge, and 3) to investigate how fatigue and activity pacing are related to physical activity after stroke rehabilitation.

METHODS: Stroke patients(N=303) were followed from baseline(T0:3-6 weeks before discharge) to 14(T1), 33(T2) and 52(T3) weeks after discharge from rehabilitation in the Rehabilitation, Sports and Active lifestyle study. Latent Class analysis was conducted to determine fatigue trajectories(T1-T3) using self-reported data of the Fatigue Severity Scale. Binomial regression analyses were performed to determine personal and health-related factors and behaviours of activity pacing associated with trajectory membership at T0. Multilevel analyses were used to investigate how self-reported physical activity levels were related to fatigue and activity pacing after rehabilitation(T1-T3).

RESULTS: Three fatigue trajectories were identified: high(N=167), low(N=33) and recovery(N=6). Compared with the low fatigue trajectory, stroke patients in the high fatigue trajectory were less likely to be highly educated(p=.023), experienced a lower quality of life(p=.004) and were more aware of their activity pacing(p=.015). Sustained physical activity was related to less fatigue(p=.006) and less awareness of activity pacing(p=.002) after rehabilitation.

CONCLUSIONS: This study identified three fatigue trajectories after stroke rehabilitation. Low education level, low quality of life scores, and high awareness of activity pacing before discharge identified stroke patients in the high fatigue trajectory. Lower levels of physical activity after stroke rehabilitation were related to a higher awareness of activity pacing, but without advice on activity pacing patients did not succeed to reduce their fatigue. These findings highlight the need to focus on the potential of activity pacing in today’s rehabilitation practice.