None listed
Conditions
Brief summary
A fatigue management guideline and new mental fatigue tools for use in therapy were developed to allow clients to regain control over their energy choices. These tools aim to promote relaxation and rests but also address other strategies for mental fatigue, such as reducing multitasking, distractions, and decision making. This project aims to evaluate the effectiveness of these new clinical tools at reducing post stroke mental fatigue, and to review their usefulness for participants and rehabilitation staff. We hypothesise that: i. Patients who engage in active treatment will show significant reduction in mental fatigue compared with standard care. ii. Patients who engage in active treatment will have significantly greater self-efficacy for daily living, and quality of life outcomes compared with patients receiving standard care. iii. Patients who engage in active treatment (including education and use of the matrix and routine tools) will perceive it to be beneficial. iiii. Therapists who use the fatigue management guideline will perceive it to be useful in enhancing their management of mental fatigue in clinical practice.
Interventions
The aim of this pilot study is twofold: 1) to evaluate the effectiveness of a novel fatigue management guideline for reducing mental fatigue and improving outcomes in adults post stroke; 2) to evaluate the usefulness of a novel fatigue management guideline for enhancing management of mental fatigue in clinical practice; using an exploratory randomised controlled trial (RCT) with two conditions: an active fatigue management (including education and use of newly developed clinical tools) and a sta
The aim of this pilot study is twofold: 1) to evaluate the effectiveness of a novel fatigue management guideline for reducing mental fatigue and improving outcomes in adults post stroke; 2) to evaluate the usefulness of a novel fatigue management guideline for enhancing management of mental fatigue in clinical practice; using an exploratory randomised controlled trial (RCT) with two conditions: an active fatigue management (including education and use of newly developed clinical tools) and a standard care group. One-on-one treatment will be carried out by a qualified Ooccupational Therapist in the Metro North Hospital and Health Service (MNHHS) Community Based Rehabilitation Team for a 10 week intervention period consisting of 1 hour weekly sessions. Participants enrolled in the treatment arm will benefit from incorporation of new clinical tools designed specifically for this study to be used by treating Occupational Therapists during therapy, including a routine fatigue management tool, matrix tool, and mental fatigue client education booklet. These tools would help clients and therapists prioritise activities and decisions, to avoid excessive multitasking and decision making, as well as provide external memory strategies to reduce cognitive load, and energy conservation strategies for optimal energy use. Participants randomly assigned to standard care (control group) will not receive education about fatigue or focus on mental fatigue in therapy, but will receive a handout from the stroke foundation on fatigue after stroke, and may receive compensatory strategies for cognitive or fatigue symptoms that are considered within the realm of routine practice. Adherence to intervention sessions will be monitored via a session attendance checklist. Treating Occupational Therapists were trained in the use of the new clinical tools 1 month prior to recruitment to the study, via a 2 hour inservice presentation which involved practicing using the following tools: The routine tool, the matrix tool and the mental fatigue client education booklet. The routine tool encourages the use of daily habits to promote breaks, relaxation and plans for optimal energy use. An electronic routine tool was developed for therapists to conveniently develop customisable daily routines for clients, and provides an option to monitor client’s adherence to habits to ensure goals are realistic and achievable within a 10 week time frame. The matrix tool was developed to help clients prioritise activities and decisions, to avoid excessive multitasking and decision making, and refer them to external memory strategies to reduce cognitive load.
Sponsors
University of Queensland
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
40 Years to No maximum
Healthy volunteers
No
Inclusion criteria
a) diagnosis of stroke; b) aged over 40 years; c) able to communicate in English; d) fatigue issues identified on care plan.
Exclusion criteria
a) pre-morbid major psychiatric or neurological disorder; b) significant visual impairment; or c) significant hearing impairment; d) severe aphasia or other communication disorder including difficulty reading or understanding written information; e) severe cognitive impairment.
Outcome results
None listed