A roadmap for research in post-stroke fatigue: Consensus-based core recommendations from the third Stroke Recovery and Rehabilitation Roundtable

Coralie English; Dawn B Simpson; Sandra A Billinger; Leonid Churilov; Kirsten G Coupland; Avril Drummond; Annapoorna Kuppuswamy; Mansur A Kutlubaev; Anners Lerdal; Amreen Mahmood; G Lorimer Moseley; Quentin J Pittman; Ellyn A Riley; Brad A Sutherland; Connie Hy Wong; Dale Corbett; Gillian Mead

doi:10.1177/17474930231189135

A roadmap for research in post-stroke fatigue: Consensus-based core recommendations from the third Stroke Recovery and Rehabilitation Roundtable

Int J Stroke. 2024 Feb;19(2):133-144. doi: 10.1177/17474930231189135. Epub 2023 Oct 12.

Authors

Coralie English^{1

2}, Dawn B Simpson^{1

2}, Sandra A Billinger³, Leonid Churilov⁴, Kirsten G Coupland^{2

5}, Avril Drummond⁶, Annapoorna Kuppuswamy⁷, Mansur A Kutlubaev⁸, Anners Lerdal^{9

10}, Amreen Mahmood¹¹, G Lorimer Moseley¹², Quentin J Pittman¹³, Ellyn A Riley¹⁴, Brad A Sutherland¹⁵, Connie Hy Wong¹⁶, Dale Corbett¹⁷, Gillian Mead¹⁸

Affiliations

¹ School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia.
² Heart and Stroke Program, Hunter Medical Research Institute, Newcastle, NSW, Australia.
³ Department of Neurology, University of Kansas Medical Centre, University of Kansas Alzheimer's Disease Research Centre, Kansas City, KS, USA.
⁴ Department of Medicine (RMH), University of Melbourne, Heidelberg, VIC, Australia.
⁵ School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia.
⁶ School of Health Sciences, University of Nottingham, Nottingham, UK.
⁷ Queen Square Institute of Neurology, University College London, London, UK.
⁸ Department of Neurology, Bashkir State Medical University, Ufa, Russia.
⁹ Department of Interdisciplinary Health Sciences, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.
¹⁰ Research Department, Lovisenberg Diaconal Hospital, Oslo, Norway.
¹¹ Faculty of Health, Health and Education, Manchester Metropolitan University, Manchester, UK.
¹² IIMPACT in Health, University of South Australia, Adelaide, SA, Australia.
¹³ Department of Physiology and Pharmacology, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.
¹⁴ Department of Communication Sciences and Disorders, Syracuse University, Syracuse, NY, USA.
¹⁵ Tasmanian School of Medicine, College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia.
¹⁶ Centre for Inflammatory Diseases, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia.
¹⁷ Department of Cellular and Molecular Medicine, University of Ottawa Roger Guindon Hall, Ottawa, ON, Canada.
¹⁸ Ageing and Health, Usher Institute, University of Edinburgh, Edinburgh, UK.

Abstract

Rationale: Fatigue affects almost half of all people living with stroke. Stroke survivors rank understanding fatigue and how to reduce it as one of the highest research priorities.

Methods: We convened an interdisciplinary, international group of clinical and pre-clinical researchers and lived experience experts. We identified four priority areas: (1) best measurement tools for research, (2) clinical identification of fatigue and potentially modifiable causes, (3) promising interventions and recommendations for future trials, and (4) possible biological mechanisms of fatigue. Cross-cutting themes were aphasia and the voice of people with lived experience. Working parties were formed and structured consensus building processes were followed.

Results: We present 20 recommendations covering outcome measures for research, development, and testing of new interventions and priority areas for future research on the biology of post-stroke fatigue. We developed and recommend the use of the Stroke Fatigue Clinical Assessment Tool.

Conclusions: By synthesizing current knowledge in post-stroke fatigue across clinical and pre-clinical fields, our work provides a roadmap for future research into post-stroke fatigue.

Keywords: Stroke; consensus; fatigue; measurement; mechanisms; recovery; rehabilitation.

MeSH terms

Consensus
Fatigue / etiology
Fatigue / therapy
Humans
Rehabilitation Research
Stroke Rehabilitation*
Stroke* / complications
Stroke* / therapy