The longitudinal relationship between fatigue, mobility, and cognitive function in older adults with chronic stroke: secondary analysis of a randomized controlled trial
Bibliographic record
Abstract
Abstract Background Fatigue is a common consequence of stroke. Cross‐sectional evidence suggests post‐stroke fatigue is negatively associated with both mobility and cognitive function. We aim to understand the longitudinal relationship between fatigue, mobility, and cognitive function in community‐dwelling adults with chronic stroke (defined as having a stroke = or > 12 months prior to study). Methods A secondary analysis of data from a 6‐month randomized controlled trial with 120 adults with chronic stroke who were randomized to group‐based, supervised: 1) exercise training; 2) complex social and mental activities; and 2) stretch and balance exercises with general education sessions. We constructed linear regression models to assess the contribution of changes in fatigue to changes in usual gait speed (over 4 meters) and to changes in cognitive function. Cognitive function was measured by the Alzheimer’s Disease Assessment Scale ‐ Cognitive Subscale (ADAS‐Cog) Plus. Higher ADAS‐Cog Plus scores indicate greater cognitive impairment. Fatigue was assessed using: 1) Fatigue Severity Scale; and 2) Visual Analogue Scale. The Fatigue Severity Scale measures fatigue severity and its impact on daily activities global fatigue The Visual Analogue Scale asks individuals to rate their global fatigue. Higher Fatigue Severity Scale and Visual Analogue Scale scores indicate greater severity and degree of fatigue, respectively. In the regression models, we controlled for experimental group, age, and biological sex. Results Reduced severity of fatigue over the 6 months was associated with improved gait speed (p = 0.02). Reduced global fatigue was associated with improved cognitive function (p = 0.04). Specifically, a reduction of 25 points on the Fatigue Severity Scale was associated with an increase of 0.1 m/s in gait speed (R‐square = 5%). For the Visual Analogue Scale, a reduction of 3.3 points in global fatigue was associated with a reduction of 1 point (i.e., improvement) in the ADAS‐Cog Plus (R‐square = 4%). Conclusions Given the prevalence and consequence of fatigue on function in chronic stroke, future work is needed to identify effective interventions.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.011 | 0.012 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.007 | 0.008 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".