Perspective on neuromuscular factors in poststroke fatigue.
OBJECTIVE
To summarize the potential origins of fatigue poststroke from a neuromuscular perspective, including stroke-induced alterations at the cortical, spinal and muscle levels.


METHODS
Perspective based on narrative literature review.


RESULTS
Fatigue is a highly prevalent, but poorly understood symptom poststroke. Neuromuscular fatigue has central and peripheral origins. Individuals with stroke experienced greater central fatigue and less peripheral fatigue during voluntary contractions of the paretic leg in comparison to healthy participants. Neuromuscular adaptations to stroke create an increased susceptibility to central fatigue, which may be a contributing factor to the increased perception of tiredness during performance of activities of daily living. Future studies should investigate whether intervention-induced cortical plasticity, gains in muscle strength and endurance will attenuate self-reported fatigability.


CONCLUSIONS
Fatigue is a common and debilitating consequence of stroke. Neuromuscular fatigue of central origin may contribute to self-reported fatigue. Continued focused and properly designed research studies should provide substantial insight into the therapeutic interventions that will improve the management of fatigue poststroke.
Graduate Program in Health and Rehabilitation Sciences, Faculty of Health Sciences, The University of Western Ontario, London, Canada.
Svetlana
S
Knorr
Charles L
CL
Rice
S Jayne
SJ
Garland
D000203:Activities of Daily Living; D005221:Fatigue / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D018763:Muscle Fatigue / Q000502:physiology*; D010291:Paresis / Q000175:diagnosis / Q000503:physiopathology*; D020521:Stroke / Q000150:complications*; D000071939:Stroke Rehabilitation