title: Is fatigue after stroke associated with physical deconditioning? A cross-sectional study in ambulatory stroke survivors.
abstract: OBJECTIVE
  To determine the relationship between a measure of fatigue and 2 indices of physical fitness, lower limb extensor power (LLEP) and walking economy.
  
  
  METHODS
  This was a cross-sectional study of patients with stroke. Fatigue was assessed by vitality (VIT) score of the Medical Outcomes Study 36-Item Short-Form Health Survey version 2 (SF-36v2). LLEP of the unaffected limb was measured using a lower leg extensor power rig. Walking economy was calculated by measuring oxygen consumption (mL·kg(-1)·m(-1)) during walking at a comfortable speed. Bivariate analyses were performed relating VIT to indices of fitness. Multiple regression analyses were also performed and included age, sex, and either SF-36v2 emotional role function or SF-36v2 mental health, as predictors of VIT.
  
  
  METHODS
  Community setting.
  
  
  METHODS
  Participants (N=66; 36 men; mean age ± SD, 71.0±9.9y) were all community dwelling, had survived a stroke, were able to walk independently, and had completed their stroke rehabilitation.
  
  
  METHODS
  Not applicable
  
  
  METHODS
  The main outcome measure is SF-36v2 (VIT), with walking economy and LLEP of the limb unaffected by the stroke being independent variables.
  
  
  RESULTS
  Walking economy was not significantly related to VIT (R=-.024, P=.86, n=60). LLEP was positively related to VIT in bivariate analysis (R=.38, P=.003, n=58). After controlling for age, sex, and SF-36 emotional role function (or SF-36v2 mental health if the extreme outlier was excluded), LLEP remained a significant predictor of VIT.
  
  
  CONCLUSIONS
  We found an association between fatigue and reduced LLEP. If a larger study confirms these findings, it would support the need to develop and test interventions to increase LLEP as a treatment for fatigue after stroke.
authors.affiliation: University of Edinburgh, Edinburgh, United Kingdom.
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Lewis
authors.forename: Amanda J
authors.initials: AJ
authors.lastname: Barugh
authors.forename: Carolyn A
authors.initials: CA
authors.lastname: Greig
authors.forename: David H
authors.initials: DH
authors.lastname: Saunders
authors.forename: Claire
authors.initials: C
authors.lastname: Fitzsimons
authors.forename: Susie
authors.initials: S
authors.lastname: Dinan-Young
authors.forename: Archie
authors.initials: A
authors.lastname: Young
authors.forename: Gillian E
authors.initials: GE
authors.lastname: Mead
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D005221:Fatigue / Q000209:etiology / Q000503:physiopathology* / Q000534:rehabilitation; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000503:physiopathology; D008297:Male; D010101:Oxygen Consumption / Q000502:physiology; D010809:Physical Fitness / Q000502:physiology*; D012044:Regression Analysis; D012307:Risk Factors; D020521:Stroke / Q000503:physiopathology*; D000071939:Stroke Rehabilitation; D011795:Surveys and Questionnaires; D016138:Walking / Q000502:physiology