title: Fatigue and pain: relationships with physical performance and patient beliefs after stroke.
abstract: 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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Roudebush Veterans Administration (VA) Medical Center, Health Services Research and Development (HSR&D) Center on Implementing Evidenced-Based Practice, Indianapolis, IN, USA.
authors.forename: Kristine K
authors.initials: KK
authors.lastname: Miller
authors.forename: Stephanie A
authors.initials: SA
authors.lastname: Combs
authors.forename: Marieke
authors.initials: M
authors.lastname: Van Puymbroeck
authors.forename: Peter A
authors.initials: PA
authors.lastname: Altenburger
authors.forename: Jacob
authors.initials: J
authors.lastname: Kean
authors.forename: Tracy A
authors.initials: TA
authors.lastname: Dierks
authors.forename: Arlene A
authors.initials: AA
authors.lastname: Schmid
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D005221:Fatigue / Q000209:etiology*; D005260:Female; D020233:Gait Disorders, Neurologic / Q000209:etiology; D006801:Humans; D008124:Locomotion; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D010146:Pain / Q000209:etiology*; D010147:Pain Measurement; D004856:Postural Balance / Q000502:physiology; D012678:Sensation Disorders / Q000209:etiology; D020521:Stroke / Q000150:complications*; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome