title: Acute-Phase Fatigue Predicts Limitations with Activities of Daily Living 18 Months after First-Ever Stroke.
abstract: BACKGROUND
  Fatigue during the acute phase following stroke has been shown to predict long-term physical health, specifically increased bodily pain and poorer self-rated general health. The aim of this analysis was to determine whether acute-phase fatigue also predicts patients' limitations in activities of daily living (ADL) 18 months after the first stroke.
  
  
  METHODS
  Patients with first-ever stroke (N = 88) were recruited upon admission at 2 hospitals in Norway. Patients were assessed within 2 weeks following admission and at 18 months using the Barthel Index of Activities of Daily Living (BI), Fatigue Severity Scale, and Beck Depression Inventory II. The relationship between acute-phase fatigue and later activity limitations (BI < 20) was evaluated using multivariate logistic regression analysis controlling for relevant covariates and acute-phase ADL function.
  
  
  RESULTS
  Acute-phase fatigue was associated with activity limitations at 18-month follow-up (P = .002), even when controlling for other predictors of ADL function, including age, gender, baseline work status, and acute-phase depressive symptoms and ADL function. Examining the reverse relationship, acute-phase activity limitations were unrelated to fatigue 18 months after stroke.
  
  
  CONCLUSIONS
  Our study indicates that acute-phase fatigue may be an independent risk factor for activity limitations 18 months after stroke. This finding suggests that effective treatments for poststroke fatigue both in the acute phase and later in the recovery period may contribute to better stroke rehabilitation.
authors.affiliation: Department of Research, Lovisenberg Diakonale Hospital, Oslo, Norway; Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway. Electronic address: anners.lerdal@medisin.uio.no.
authors.forename: Anners
authors.initials: A
authors.lastname: Lerdal
authors.affiliation: Department of Research, Lovisenberg Diakonale Hospital, Oslo, Norway; Department of Family Health Care Nursing, University of California, San Francisco, California.
authors.forename: Caryl L
authors.initials: CL
authors.lastname: Gay
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005221:Fatigue / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013223:Statistics as Topic; D020521:Stroke / Q000150:complications* / Q000453:epidemiology / Q000523:psychology*; D000071939:Stroke Rehabilitation
keywords: Activities of daily living; activity limitation; fatigue; rehabilitation; stroke