卒中后疲劳纵向研究的范围综述

doi:10.3761/j.issn.0254-1769.2025.07.005

摘要/Abstract

摘要：

目的对卒中后疲劳纵向研究进行范围综述，明确卒中后疲劳的测量时间、评估工具、变化趋势及影响因素，为今后开展相关科学研究和临床实践提供参考。方法遵循范围综述审查方法，系统检索Web of Science、PubMed、CINAHL、Embase、中国知网、中国生物医学文献数据库、万方数据库、维普数据库，检索时限为建库至2024年12月15日。结果共纳入41篇文献，高频使用的测量时间点为卒中后3、6、12个月。检索到10个评估工具，最多选用的是疲劳严重程度量表。大多数研究支持卒中后疲劳发生率在脑卒中6个月内呈下降趋势，6~12个月呈上升趋势，12个月以上呈下降趋势。卒中后疲劳受人口学因素、疾病因素、生理因素、心理社会因素及应对行为因素影响。结论卒中后疲劳纵向研究在脑卒中1年内比较集中，但恢复期研究不足，特异性评估工具有待进一步探讨。卒中后疲劳变化趋势在不同阶段存在差异，且存在群体异质性。未来研究需进一步探讨卒中后疲劳的影响因素。

关键词: 卒中后疲劳, 纵向研究, 变化趋势, 范围综述, 护理

Abstract:

Objective To identify the measurement time，assessment tools，changing trends，factors in longitudinal studies on post stroke fatigue. Methods Web of Science，PubMed，CINAHL，Embase，CNKI，CBM，Wanfang，and VIP database were retrieved from inception until December 15，2024. Results A total of 41 papers were included. The measurement time points used with high frequency were 3，6，and 12 months after stroke. 10 assessment tools were retrieved and the fatigue severity scale was most selected. The majority of the studies supported that the incidence of post stroke fatigue showed a decreasing trend within 6 months after stroke，an increasing trend from 6 to 12 months，and a decreasing or steady decreasing trend from 12 months. Post stroke fatigue is influenced by demographic，disease，physiologic，psychological，and coping factors. Conclusion The longitudinal studies on post stroke fatigue focused less than 1 year after stroke，but the recovery period is understudied and specific assessment tools need to be further explored. The trend of post stroke fatigue varies at different stages and exists heterogeneity. Future studies should be optimized to explore influence factors.

Key words: Post Stroke Fatigue, Longitudinal Research, Variation Trend, Scoping Review, Nursing Care

冯伟清, 陈研博, 蔡洹, 阮嘉慧, 何秀娴, 李琨. 卒中后疲劳纵向研究的范围综述[J]. 中华护理杂志, 2025, 60(7): 799-805.

FENG Weiqing, CHEN Yanbo, CAI Huan, RUAN Jiahui, HE Xiuxian, LI Kun. A scoping review of the longitudinal studies on post stroke fatigue[J]. Chinese Journal of Nursing, 2025, 60(7): 799-805.

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参考文献 48

[1]	NICE. Stroke rehabilitation in adults[EB/OL]. (2023-10-18)[2024-11-10]. https://www.nice.org.uk/search?q=Stroke+rehabilitation+in+adults.
[2]	Zhan J, Zhang PM, Wen H, et al. Global prevalence estimates of poststroke fatigue:a systematic review and meta-analysis[J]. Int J Stroke, 2023, 18(9):1040-1050.
[3]	史慧玲, 王清, 蒋园园, 等. 脑卒中患者运动康复体验质性研究的Meta整合[J]. 中华护理杂志, 2024, 59(11):1397-1404. DOI URL
	Shi HL, Wang Q, Jiang YY, et al. Exercise rehabilitation experience of stroke patients:a qualitative meta-synthesis[J]. Chin J Nurs, 2024, 59(11):1397-1404.
[4]	张敏, 王清, 史慧玲, 等. 急性缺血性脑卒中患者早期活动影响因素的质性研究[J]. 中华护理杂志, 2023, 58(17):2112-2118. DOI URL
	Zhang M, Wang Q, Shi HL, et al. Influencing factors of early activities in patients with acute ischemic stroke:a qualitative study[J]. Chin J Nurs, 2023, 58(17):2112-2118.
[5]	Vollertsen J, Björk M, Norlin AK, et al. The impact of post-stroke fatigue on work and other everyday life activities for the working age population-a registry-based cohort study[J]. Ann Med, 2023, 55(2):2269961.
[6]	Huang HM, Lu MX, Zhong JH, et al. Prevalence,trajectory,and predictors of post-stroke fatigue in older adults[J]. Arch Phys Med Rehabil, 2024: S0003-S9993(24)01371-6.
[7]	Seves BL, Hoekstra T, Hoekstra F, et al. Unravelling perceived fatigue and activity pacing in maintaining a physically active lifestyle after stroke rehabilitation:a longitudinal cohort study[J]. Disabil Rehabil, 2021, 43(24):3492-3502.
[8]	Kjeverud A, Østlie K, Schanke AK, et al. Trajectories of fatigue among stroke patients from the acute phase to 18 months post-injury:a latent class analysis[J]. PLoS One, 2020, 15(4):e0231709.
[9]	Snaphaan L, van der Werf S, de Leeuw FE. Time course and risk factors of post-stroke fatigue:a prospective cohort study[J]. Eur J Neurol, 2011, 18(4):611-617. DOI PMID
[10]	Hawkins L, Lincoln NB, Sprigg N, et al. The Nottingham Fatigue After Stroke(NotFAST) study:results from follow-up six months after stroke[J]. Top Stroke Rehabil, 2017, 24(8):592-596. DOI PMID
[11]	Lerdal A, Lee KA, Bakken LN, et al. The course of fatigue during the first 18 months after first-ever stroke:a longitudinal study[J]. Stroke Res Treat, 2012, 2012:126275.
[12]	Tang WK, Chen YK, Liang HJ, et al. Subcortical white matter infarcts predict 1-year outcome of fatigue in stroke[J]. BMC Neurol, 2014, 14:234. DOI PMID
[13]	Tao CR, Gu MM, Xu PF, et al. Stressful life events can predict post-stroke fatigue in patients with ischemic stroke[J]. Eur J Neurol, 2021, 28(9):3080-3088.
[14]	Bhimani R, Chappuis D, Mathiason MA, et al. Spasticity,pain,and fatigue:are they associated with functional outcomes in people with stroke?[J]. Rehabil Nurs, 2022, 47(2):60-71. DOI PMID
[15]	Skånér Y, Nilsson GH, Sundquist K, et al. Self-rated health,symptoms of depression and general symptoms at 3 and 12 months after a first-ever stroke:a municipality-based study in Sweden[J]. BMC Fam Pract, 2007, 8:61. PMID
[16]	Sarfo FS, Berchie P, Singh A, et al. Prevalence,trajectory,and predictors of poststroke fatigue among ghanaians[J]. J Stroke Cerebrovasc Dis, 2019, 28(5):1353-1361. DOI PMID
[17]	Su Y, Asamoto M, Yuki M, et al. Predictors and short-term outcomes of post-stroke fatigue in initial phase of transition from hospital to home:a prospective observational study[J]. J Adv Nurs, 2021, 77(4):1825-1838.
[18]	van Eijsden HM, van de Port IG, Visser-Meily JM, et al. Poststroke fatigue:who is at risk for an increase in fatigue?[J]. Stroke Res Treat, 2012, 2012:863978.
[19]	Schepers VP, Visser-Meily AM, Ketelaar M, et al. Poststroke fatigue:course and its relation to personal and stroke-related factors[J]. Arch Phys Med Rehabil, 2006, 87(2):184-188.
[20]	Radman N, Staub F, Aboulafia-Brakha T, et al. Poststroke fatigue following minor infarcts:a prospective study[J]. Neurology, 2012, 79(14):1422-1427.
[21]	Rutkowski NA, Sabri E, Yang C. Post-stroke fatigue:a factor associated with inability to return to work in patients <60 years:a 1-year follow-up[J]. PLoS One, 2021, 16(8):e0255538.
[22]	Andersen G, Christensen D, Kirkevold M, et al. Post-stroke fatigue and return to work:a 2-year follow-up[J]. Acta Neurol Scand, 2012, 125(4):248-253. DOI PMID
[23]	Delva MY, Delva II, Lytvynenko NV. Post-stroke fatigue and its dimensions over the second half year after stroke[J]. Wiad Lek, 2018, 71(2):314-317.
[24]	Gu MM, Xiao LL, Wang JJ, et al. Obesity and poststroke fatigue:a 2-year longitudinal study[J]. Neurol Ther, 2021, 10(2):955-969.
[25]	Delva M, Delva I. Neuroimaging characteristics and post-stroke fatigue within the first 6 months after ischemic strokes[J]. Georgian Med News, 2017(271):91-95. PMID
[26]	van de Port IG, Kwakkel G, Schepers VP, et al. Is fatigue an independent factor associated with activities of daily living,instrumental activities of daily living and health-related quality of life in chronic stroke?[J]. Cerebrovasc Dis, 2007, 23(1):40-45. DOI PMID
[27]	Byun E, McCurry SM, Kwon S, et al. Fatigue,toll-like receptor 4,and pro-inflammatory cytokines in adults with subarachnoid hemorrhage:a 6-month longitudinal study[J]. Biol Res Nurs, 2024, 26(2):192-201.
[28]	Lerdal A, Gay CL. Fatigue in the acute phase after first stroke predicts poorer physical health 18 months later[J]. Neurology, 2013, 81(18):1581-1587. DOI PMID
[29]	Liu XX. Fatigue and depression in Chinese stroke patients:a 1-year longitudinal study[D]. Hong kong: The Chinese University of Hong Kong, 2016.
[30]	Braaten RS, Askim T, Gunnes M, et al. Fatigue and activity after stroke. Secondary results from the Life After Stroke study[J]. Physiother Res Int, 2020, 25(4): e1851.
[31]	Scopelliti G, Rossi C, Kuchcinski G, et al. Fatigue after spontaneous intracerebral haemorrhage:prevalence and associated factors[J]. Neurol Sci, 2024, 45(5):2127-2135.
[32]	Harmsen WJ, Ribbers GM, Heijenbrok-Kal MH, et al. Fatigue after aneurysmal subarachnoid hemorrhage is highly prevalent in the first-year postonset and related to low physical fitness:a longitudinal study[J]. Am J Phys Med Rehabil, 2019, 98(1):7-13.
[33]	Delva M, Lytvynenko N, Delva I. Factors associated with the time-based phenomenology of post-stroke fatigue over the first year after stroke occurrence[J]. Georgian Med News, 2018(279):92-97. PMID
[34]	Kirchberger I, Wallner F, Linseisen J, et al. Factors associated with early and late post-stroke fatigue in patients with mild impairment results from the stroke cohort study Augsburg[J]. Front Neurol, 2022, 13:852486.
[35]	Wu SM, Duncan F, Anderson NH, et al. Exploratory cohort study of associations between serum C-reactive protein and fatigue after stroke[J]. PLoS One, 2015, 10(11):e0143784.
[36]	Juárez-Belaúnde A, Soto-León V, Dileone M, et al. Early poststroke clinically significant fatigue predicts functional independence:a prospective longitudinal study[J]. Front Neurol, 2024, 15:1364446.
[37]	Christensen D, Johnsen SP, Watt T, et al. Dimensions of post-stroke fatigue:a two-year follow-up study[J]. Cerebrovasc Dis, 2008, 26(2):134-141. DOI PMID
[38]	Wang JJ, Li FL, Xiao LL, et al. Depressed TSH level as a predictor of poststroke fatigue in patients with acute ischemic stroke[J]. Neurology, 2018, 91(21):e1971-e1978.
[39]	Duncan F, Greig C, Lewis S, et al. Clinically significant fatigue after stroke:a longitudinal cohort study[J]. J Psychosom Res, 2014, 77(5):368-373. DOI PMID
[40]	Becker CJ, Lisabeth LD, Kwicklis M, et al. Association between sleep-disordered breathing and post-stroke fatigue in patients with ischemic stroke[J]. J Stroke Cerebrovasc Dis, 2024, 33(6):107701.
[41]	Luzum G, Thrane G, Aam S, et al. A machine learning approach to predict post-stroke fatigue. The Nor-COAST study[J]. Arch Phys Med Rehabil, 2024, 105(5):921-929.
[42]	张文丽. 缺血性卒中后疲劳的影响因素分析[D]. 广州: 南方医科大学, 2023.
	Zhang WL. Analysis of influencing factors of fatigue after ischemic stroke[D]. Guangzhou: Southern Medical University, 2023.
[43]	王敏. 缺血性脑卒中患者疲劳发生率及其影响因素研究[D]. 郑州: 郑州大学, 2017.
	Wang M. Study on the incidence of fatigue and its influencing factors in patients with ischemic stroke[D]. Zhengzhou: Zhengzhou University, 2017.
[44]	熊小兰, 谢健, 邓鸿元, 等. 中老年脑卒中患者疲劳发展轨迹及其影响因素的研究[J]. 实用临床医药杂志, 2024, 28(19):123-128,133.
	Xiong XL, Xie J, Deng HY, et al. Fatigue development trajectory and its influencing factors in middle-aged and elderly patients with stroke[J]. J Clin Med Pract, 2024, 28(19):123-128,133.
[45]	邱雪斌, 繆小红, 夏敏棋, 等. 脑卒中患者疲劳轨迹的潜在类别及影响因素分析[J]. 中华护理杂志, 2024, 59(19):2375-2381. DOI URL
	Qiu XB, Miao XH, Xia MQ, et al. Potential categories and influencing factors of fatigue trajectories in stroke patients[J]. Chin J Nurs, 2024, 59(19):2375-2381. DOI URL
[46]	臧爽, 崔赢, 倪翠萍, 等. 卒中后疲劳评估工具的范围综述[J]. 中华护理杂志, 2023, 58(1):46-54. DOI URL
	Zang S, Cui Y, Ni CP, et al. A scoping review of assessment tools for post-stroke fatigue[J]. Chin J Nurs, 2023, 58(1):46-54. DOI URL
[47]	Wu SM, Mead G, MacLeod M, et al. Model of understanding fatigue after stroke[J]. Stroke, 2015, 46(3):893-898. DOI PMID
[48]	袁潇逸, 邢唯杰. 纵向混合研究在护理领域中的应用进展[J]. 中华护理杂志, 2024, 59(2):244-249. DOI URL
	Yuan XY, Xing WJ. Longitudinal mixed methods and its application progress in nursing[J]. Chin J Nurs, 2024, 59(2):244-249. DOI URL