Evaluation of walking speed (10m walking test) in patients with chronic hemiparesis after at least 3 consecutive botulinum neurotoxin injections while patients follow a guided self-rehabilitation contract
Annals of Physical and Rehabilitation Medicine
e243 single stroke at least 12 months previously, with recovery of Indoor walking and home return. Fatigue was assessed by a multidimensional scale, the MFI-20 which allowed determining the fatigue level in its four dimensions (general fatigue, mental fatigue, reduced activity and lack of motivation). We examined possible associations between the level of fatigue in each of its dimensions and different parameters related to the patient (age, sex, body mass index), to the brain injury (etiology,
... side, duration), and to other stroke complications (motor deficit, disability level, anxiety, depression, sleep disturbance and pain). Disability was determined by the Barthel Index score. Anxiety and depression were assessed by the HAD scale. Results.-The different domains of fatigue identified by the MFI-20 were present at equivalent levels in the patients without predominance of one domain over the others. "General fatigue" and "mental fatigue" were strongly correlated with anxiety and depression. "Lack of motivation" was correlated with sleep disturbance (P = 0.047) and with depression (P = 0.047). "Reduced activity" was correlated with anxiety (P = 0.02). On the other hand, there were no significant correlations of the different domains of fatigue with the other parameters studied. Conclusion.-Post-stroke fatigue is multidimensional. Some comorbidities (depression, anxiety, sleep disorders) that are accessible to treatment are associated with a higher risk of fatigue in each of its dimensions.