Cognitive and Graded Activity Training Can Alleviate Persistent Fatigue After Stroke: A Randomized, Controlled Trial

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....

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Bibliographic Details
Published in:Stroke (1970) 2012-04, Vol.43 (4), p.1046-1051
Main Authors: ZEDLITZ, Aglaia M. E. E, RIETVELD, Toni C. M, GEURTS, Alexander C, FASOTTI, Luciano
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Biological and medical sciences
Cognitive Therapy - methods
Female
Follow-Up Studies
Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy
Humans
Male
Medical sciences
Mental Fatigue - etiology
Mental Fatigue - therapy
Middle Aged
Nervous system (semeiology, syndromes)
Neurology
Stroke - complications
Stroke Rehabilitation
Time Factors
Vascular diseases and vascular malformations of the nervous system
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Summary: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
ISSN:0039-2499
1524-4628
DOI:10.1161/STROKEAHA.111.632117