Cognitive and Graded Activity Training Can Alleviate Persistent Fatigue After Stroke
Open Access
- 1 April 2012
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Stroke
- Vol. 43 (4), 1046-1051
- https://doi.org/10.1161/strokeaha.111.632117
Abstract
Fatigue is a common, persistent consequence of stroke, and no evidence-based treatments are currently available to alleviate fatigue. A new treatment combining cognitive therapy (CO) with graded activity training (GRAT), called COGRAT, was developed to alleviate fatigue and fatigue-related symptoms. This study compared the effectiveness of the COGRAT intervention with a CO-only intervention after a 3-month qualification period without intervention. This randomized, controlled, assessor-blind clinical trial was conducted in 8 rehabilitation centers. Eighty-three stroke patients (>4 months after stroke) were randomly assigned to 12 weeks of CO or COGRAT after qualification. Seventy-three patients completed treatment and 68 were available at follow-up. Primary outcomes (Checklist Individual Strength–subscale Fatigue (CIS-f); self-observation list–fatigue (SOL-f)) and secondary outcomes (Hospital Anxiety and Depression Scale, Stroke-Adapted Sickness Impact Profile, SOL-pain, SOL-sleep-D, 6-minute walk test) were collected at baseline (before and after qualification period) and after treatment (immediate and 6-month follow-up). The qualification period showed stable outcome measures. Both treatments showed significant beneficial effects on fatigue (CIS-f: η p 2 =0.48, P p 2 =0.20, P <0.001). A 12-week cognitive therapy program can alleviate persistent fatigue after stroke. The best results are obtained when cognitive therapy is augmented with graded activity training. URL: http://www.trialregister.nl . Unique identifier: NTR2704.Keywords
This publication has 28 references indexed in Scilit:
- Time course and risk factors of post-stroke fatigue: a prospective cohort studyEuropean Journal of Neurology, 2010
- Cognitive and Functional Outcome After Aneurysmal Subarachnoid HemorrhageStroke, 2010
- Poststroke Fatigue—A ReviewJournal of Pain and Symptom Management, 2009
- Validity of the Hospital Anxiety and Depression Scale to assess depression and anxiety following traumatic brain injury as compared with the Structured Clinical Interview for DSM-IVJournal of Affective Disorders, 2009
- Guided self-instructions for people with chronic fatigue syndrome: randomised controlled trialThe British Journal of Psychiatry, 2008
- Dimensions of Post-Stroke Fatigue: A Two-Year Follow-Up StudyCerebrovascular Diseases, 2008
- Fatigue at Long-Term Follow-Up in Young Adults with Cerebral InfarctionCerebrovascular Diseases, 2005
- World Medical Association Declaration of HelsinkiJAMA, 2000
- Dimensional assessment of chronic fatigue syndromeJournal of Psychosomatic Research, 1994
- The Hospital Anxiety and Depression ScaleActa Psychiatrica Scandinavica, 1983