Svetlana Knorr1, Charles L Rice, S Jayne Garland. 1. Graduate Program in Health and Rehabilitation Sciences, Faculty of Health Sciences, The University of Western Ontario, London, Canada.
Abstract
PURPOSE: To summarize the potential origins of fatigue poststroke from a neuromuscular perspective, including stroke-induced alterations at the cortical, spinal and muscle levels. METHOD: Perspective based on narrative literature review. RESULTS: Fatigue is a highly prevalent, but poorly understood symptom poststroke. Neuromuscular fatigue has central and peripheral origins. Individuals with stroke experienced greater central fatigue and less peripheral fatigue during voluntary contractions of the paretic leg in comparison to healthy participants. Neuromuscular adaptations to stroke create an increased susceptibility to central fatigue, which may be a contributing factor to the increased perception of tiredness during performance of activities of daily living. Future studies should investigate whether intervention-induced cortical plasticity, gains in muscle strength and endurance will attenuate self-reported fatigability. CONCLUSIONS: Fatigue is a common and debilitating consequence of stroke. Neuromuscular fatigue of central origin may contribute to self-reported fatigue. Continued focused and properly designed research studies should provide substantial insight into the therapeutic interventions that will improve the management of fatigue poststroke.
PURPOSE: To summarize the potential origins of fatigue poststroke from a neuromuscular perspective, including stroke-induced alterations at the cortical, spinal and muscle levels. METHOD: Perspective based on narrative literature review. RESULTS:Fatigue is a highly prevalent, but poorly understood symptom poststroke. Neuromuscular fatigue has central and peripheral origins. Individuals with stroke experienced greater central fatigue and less peripheral fatigue during voluntary contractions of the paretic leg in comparison to healthy participants. Neuromuscular adaptations to stroke create an increased susceptibility to central fatigue, which may be a contributing factor to the increased perception of tiredness during performance of activities of daily living. Future studies should investigate whether intervention-induced cortical plasticity, gains in muscle strength and endurance will attenuate self-reported fatigability. CONCLUSIONS:Fatigue is a common and debilitating consequence of stroke. Neuromuscular fatigue of central origin may contribute to self-reported fatigue. Continued focused and properly designed research studies should provide substantial insight into the therapeutic interventions that will improve the management of fatigue poststroke.
Authors: David A Cunningham; Daniel Janini; Alexandria Wyant; Corin Bonnett; Nicole Varnerin; Vishwanath Sankarasubramanian; Kelsey A Potter-Baker; Sarah Roelle; Xiaofeng Wang; Vlodek Siemionow; Guang H Yue; Ela B Plow Journal: Neuroscience Date: 2016-04-04 Impact factor: 3.590
Authors: Allison S Hyngstrom; Spencer A Murphy; Jennifer Nguyen; Brian D Schmit; Francesco Negro; David D Gutterman; Matthew J Durand Journal: J Appl Physiol (1985) Date: 2018-02-08