Article

Post-stroke fatigue is a common and debilitating complaint, which has
only recently received attention in clinical rehabilitation. Until now, no evidence-based treatments have been available for the condition. Therefore, a new
treatment was designed to reduce post-stroke fatigue complaints: Cognitive and
Graded Activity Training (COGRAT). RATIONALE: Following the premise that
post-stroke fatigue is primarily caused by brain damage, the treatment aims to
prevent fatigue and to manage existing fatigue symptoms. The purpose of the added
graded activity programme is to reduce fatigue by changing cognitions and
enhancing physical fitness. THEORY INTO PRACTICE: COGRAT consists of a cognitive
treatment and graded activity programme in small groups over 12 weeks. In the
cognitive treatment, patients receive education on post-stroke fatigue and
register their activities and fatigue to gain insight into their daily agenda and
fatigability. Patients are then taught several compensation strategies. Cognitive
behavioural therapy is used to diminish anxiety, facilitate behavioural change
and manage fatigue symptoms. The graded activity programme consists of walking on
a treadmill, strength training and home work assignments. Maximum heart rate and
strength are increased from 40% at the beginning of the training to a maximum of
70%. CONSIDERATIONS FOR FUTURE IMPROVEMENTS: COGRAT is currently being evaluated
in outpatients with severe post-stroke fatigue in a multicentre randomized
controlled trial. Preliminary data suggest both positive short- and long-term effects. Adaptations for other neurological patient groups suffering from fatigue are suggested.

Langue : ANGLAIS