Cognitive and graded activity training can alleviate persistent fatigue after stroke: A randomized, controlled trial
Publication year
2012Number of pages
6 p.
Source
Stroke, 43, 4, (2012), pp. 1046-1051ISSN
Publication type
Article / Letter to editor

Display more detailsDisplay less details
Organization
SW OZ DCC NRP
Journal title
Stroke
Volume
vol. 43
Issue
iss. 4
Languages used
English (eng)
Page start
p. 1046
Page end
p. 1051
Subject
DI-BCB_DCC_Theme 3: Plasticity and Memory; Neuropsychology and rehabilitation psychology; Neuro- en revalidatiepsychologieAbstract
Background and Purpose-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.
Methods-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).
Results-The qualification period showed stable outcome measures. Both treatments showed significant beneficial effects on fatigue (CIS-f: eta(2)(p)=0.48, P<0.001) and other outcomes (except pain and anxiety) with intention-to-treat analyses. Gains for the COGRAT group exceeded those in the CO group on number of individuals showing clinical improvement on the CIS-f (>= 8 points: 58% versus 24%) and on physical endurance (eta(2)(p)=0.20, P<0.001).
Conclusions-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.
This item appears in the following Collection(s)
- Academic publications [202563]
- Electronic publications [100645]
- Faculty of Social Sciences [27083]
- Open Access publications [69412]
Upload full text
Use your RU credentials (u/z-number and password) to log in with SURFconext to upload a file for processing by the repository team.