Abstracts presented at the SMART STROKES Conference 2022 18-19 th August, Sydney, NSW

Abstract

Introduction: Post-stroke fatigue affects at least half of all stroke survivors , and there is limited evidence to guide clinicians in the management of symptoms. Aims: We aimed to understand how Australian clinicians assess and manage post-stroke fatigue. Furthermore, we aimed to explore how confident clinicians are in treating post-stroke fatigue. Methods: We conducted a cross-sectional online survey targeting any Australian health professional who worked with people with post-stroke fatigue. Questions (closed and open) explored clinician and service characteristics , the post-stroke fatigue management strategies clinicians provided (assessment and interventions) and self-rated confidence (0-10 visual analogue scale). Descriptive statistics were used to summarize participant demographics, frequency of responses to dichotomized questions and distribution of responses for visual analogue scale questions. Free text responses were coded and categorized. Results: Respondents (n=60) were predominantly occupational therapists (52%, 31/60) and physiotherapists (40%, 24/60), working in NSW and Victoria (67% combined). Interventions were delivered in individual sessions (68%), or individual combined with group (30%) format. Few respondents (8%, 5/60) reported regular use of a formal assessment tool. The three most commonly reported interventions were energy optimization strategies, education, and exercise. In addition, strategies such as sleep quality, adaptation strategies, medical assessment, pharmacology, psychology, and nutritional advice were reported. Self-reported confidence in managing post-stroke fatigue was rated a mean 5.9 (SD 1.8) points out of 10. Conclusion: Physiotherapists and occupational therapists suggest strategies for post-stroke fatigue including energy optimization strategies, education , and exercise. Evidence and experience from other conditions with fatigue are used as a rationale for treatment. Formal assessment of fatigue is lacking. Clinicians need robustly designed and tested clinical trials of fatigue management programs, and assessment tools to help them address post-stroke fatigue in clinical practice.