Background: Post-stroke fatigue (PSF) is common and significantly alters quality of life; mitigation strategies focus on reducing physical activity (PA) and ensuring adequate sleep. However, evidence from previous studies exploring the impact of these lifestyle factors on PSF is conflicting. This prospective, correlational observational study aims to investigate the relationship between perceived PSF, PA and sleep in an adult, community-living stroke population.
Method: Stroke survivors experiencing PSF (n=16, median age=62 years, time post-stroke=41 months) were recruited. Participants’ sleep quality (total duration, sleep efficiency, onset and awakenings) was captured using overnight actigraphy, PA levels (energy expenditure (EE), total step count and time spent sedentary) were recorded using accelerometers, and self-report measures of fatigue (Fatigue Severity Scale, Visual Analogue Scale for Fatigue, Fatigue Scale for Motor and Cognitive Function), physical functioning (6-Minute Walk Test) and sleep (Leeds Sleep Evaluation Questionnaire) were collected the day following actigraphy and accelerometer data.
Results: All participants reported moderate-high levels of fatigue and recorded moderate levels of physical activity across the 7-day study period. Significant associations were observed between perceived PSF and changes in EE (r=-0.45, p=0.012) and step count (r=-0.38, p=0.037). No significant associations were observed between perceived PSF and changes in sleep quality (duration r=-0.28, p=0.179; onset r=0.27, p=0.195; efficiency r=-0.29, p=0.172; awakenings r=-0.32, p =0.122).
Conclusion: Increased PA may reduce daily perceived PSF, although we acknowledge the sample size limitations of this study. Findings should be considered when discussing PSF symptoms and planning rehabilitation programs for those living with chronic stroke.