Unraveling the interplay between daily life fatigue and physical activity after subarachnoid hemorrhage: an ecological momentary assessment and accelerometry study
Abstract Background Fatigue is one of the most commonly reported symptoms after subarachnoid hemorrhage (SAH) and is indirectly associated with physical activity (PA). Associations between fatigue and PA are primarily examined based on conventional measures (i.e. a single fatigue score or average PA...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-09-01
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| Series: | Journal of NeuroEngineering and Rehabilitation |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12984-023-01241-5 |
| _version_ | 1827635372698370048 |
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| author | Elisabeth A. de Vries Majanka H. Heijenbrok-Kal Fop van Kooten Marco Giurgiu Gerard M. Ribbers Rita J.G. van den Berg-Emons Johannes B.J. Bussmann |
| author_facet | Elisabeth A. de Vries Majanka H. Heijenbrok-Kal Fop van Kooten Marco Giurgiu Gerard M. Ribbers Rita J.G. van den Berg-Emons Johannes B.J. Bussmann |
| author_sort | Elisabeth A. de Vries |
| collection | DOAJ |
| description | Abstract Background Fatigue is one of the most commonly reported symptoms after subarachnoid hemorrhage (SAH) and is indirectly associated with physical activity (PA). Associations between fatigue and PA are primarily examined based on conventional measures (i.e. a single fatigue score or average PA levels), thereby assuming that fatigue and PA do not fluctuate over time. However, levels of fatigue and PA may not be stable and may interrelate dynamically in daily life. Insight in direct relationships between fatigue and PA in daily life, could add to the development of personalized rehabilitation strategies. Therefore we aimed to examine bidirectional relationships between momentary fatigue and PA in people with SAH. Methods People (n = 38) with SAH who suffer from chronic fatigue were included in an observational study using Ecological Momentary Assessment (EMA) and accelerometry. Momentary fatigue was assessed on a scale from 1 to 7 (no to extreme fatigue), assessed with 10–11 prompts per day for 7 consecutive days using EMA with a mobile phone. PA was continuously measured during this 7-day period with a thigh-worn Activ8 accelerometer and expressed as total minutes of standing, walking, running and cycling in a period of 45 min before and after a momentary fatigue prompt. Multilevel mixed model analyses including random effects were conducted. Results Mean age was 53.2 years (SD = 13.4), 58% female, and mean time post SAH onset was 9.5 months (SD = 2.1). Multilevel analyses with only time effects to predict fatigue and PA revealed that fatigue significantly (p < 0.001) increased over the day and PA significantly (p < 0.001) decreased. In addition, more PA was significantly associated with higher subsequent fatigue (β = 0.004, p < 0.05) and higher fatigue was significantly associated with less subsequent PA (β=-0.736, p < 0.05). Moreover, these associations significantly differed between participants (p < 0.001). Conclusions By combining EMA measures of fatigue with accelerometer-based PA we found that fatigue and PA are bidirectionally associated. In addition, these associations differ among participants. Given these different bidirectional associations, rehabilitation aimed at reducing fatigue should comprise personalized strategies to improve both fatigue and PA simultaneously, for example by combining exercise therapy with cognitive behavioral and/or energy management therapy. |
| first_indexed | 2024-03-09T15:26:49Z |
| format | Article |
| id | doaj.art-f3cec9f201404e699e1d8292a32a5f3f |
| institution | Directory Open Access Journal |
| issn | 1743-0003 |
| language | English |
| last_indexed | 2024-03-09T15:26:49Z |
| publishDate | 2023-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of NeuroEngineering and Rehabilitation |
| spelling | doaj.art-f3cec9f201404e699e1d8292a32a5f3f2023-11-26T12:32:20ZengBMCJournal of NeuroEngineering and Rehabilitation1743-00032023-09-012011910.1186/s12984-023-01241-5Unraveling the interplay between daily life fatigue and physical activity after subarachnoid hemorrhage: an ecological momentary assessment and accelerometry studyElisabeth A. de Vries0Majanka H. Heijenbrok-Kal1Fop van Kooten2Marco Giurgiu3Gerard M. Ribbers4Rita J.G. van den Berg-Emons5Johannes B.J. Bussmann6Erasmus MC, Department of Rehabilitation Medicine, University Medical Center RotterdamErasmus MC, Department of Rehabilitation Medicine, University Medical Center RotterdamErasmus MC, Department of Neurology, University Medical Center RotterdamInstitute for Sports and Sports Science, Mental mHealth lab, Karlsruhe Institute of TechnologyErasmus MC, Department of Rehabilitation Medicine, University Medical Center RotterdamErasmus MC, Department of Rehabilitation Medicine, University Medical Center RotterdamErasmus MC, Department of Rehabilitation Medicine, University Medical Center RotterdamAbstract Background Fatigue is one of the most commonly reported symptoms after subarachnoid hemorrhage (SAH) and is indirectly associated with physical activity (PA). Associations between fatigue and PA are primarily examined based on conventional measures (i.e. a single fatigue score or average PA levels), thereby assuming that fatigue and PA do not fluctuate over time. However, levels of fatigue and PA may not be stable and may interrelate dynamically in daily life. Insight in direct relationships between fatigue and PA in daily life, could add to the development of personalized rehabilitation strategies. Therefore we aimed to examine bidirectional relationships between momentary fatigue and PA in people with SAH. Methods People (n = 38) with SAH who suffer from chronic fatigue were included in an observational study using Ecological Momentary Assessment (EMA) and accelerometry. Momentary fatigue was assessed on a scale from 1 to 7 (no to extreme fatigue), assessed with 10–11 prompts per day for 7 consecutive days using EMA with a mobile phone. PA was continuously measured during this 7-day period with a thigh-worn Activ8 accelerometer and expressed as total minutes of standing, walking, running and cycling in a period of 45 min before and after a momentary fatigue prompt. Multilevel mixed model analyses including random effects were conducted. Results Mean age was 53.2 years (SD = 13.4), 58% female, and mean time post SAH onset was 9.5 months (SD = 2.1). Multilevel analyses with only time effects to predict fatigue and PA revealed that fatigue significantly (p < 0.001) increased over the day and PA significantly (p < 0.001) decreased. In addition, more PA was significantly associated with higher subsequent fatigue (β = 0.004, p < 0.05) and higher fatigue was significantly associated with less subsequent PA (β=-0.736, p < 0.05). Moreover, these associations significantly differed between participants (p < 0.001). Conclusions By combining EMA measures of fatigue with accelerometer-based PA we found that fatigue and PA are bidirectionally associated. In addition, these associations differ among participants. Given these different bidirectional associations, rehabilitation aimed at reducing fatigue should comprise personalized strategies to improve both fatigue and PA simultaneously, for example by combining exercise therapy with cognitive behavioral and/or energy management therapy.https://doi.org/10.1186/s12984-023-01241-5FatiguePhysical activitySubarachnoid hemorrhageEcological momentary assessmentAccelerometryRehabilitation |
| spellingShingle | Elisabeth A. de Vries Majanka H. Heijenbrok-Kal Fop van Kooten Marco Giurgiu Gerard M. Ribbers Rita J.G. van den Berg-Emons Johannes B.J. Bussmann Unraveling the interplay between daily life fatigue and physical activity after subarachnoid hemorrhage: an ecological momentary assessment and accelerometry study Journal of NeuroEngineering and Rehabilitation Fatigue Physical activity Subarachnoid hemorrhage Ecological momentary assessment Accelerometry Rehabilitation |
| title | Unraveling the interplay between daily life fatigue and physical activity after subarachnoid hemorrhage: an ecological momentary assessment and accelerometry study |
| title_full | Unraveling the interplay between daily life fatigue and physical activity after subarachnoid hemorrhage: an ecological momentary assessment and accelerometry study |
| title_fullStr | Unraveling the interplay between daily life fatigue and physical activity after subarachnoid hemorrhage: an ecological momentary assessment and accelerometry study |
| title_full_unstemmed | Unraveling the interplay between daily life fatigue and physical activity after subarachnoid hemorrhage: an ecological momentary assessment and accelerometry study |
| title_short | Unraveling the interplay between daily life fatigue and physical activity after subarachnoid hemorrhage: an ecological momentary assessment and accelerometry study |
| title_sort | unraveling the interplay between daily life fatigue and physical activity after subarachnoid hemorrhage an ecological momentary assessment and accelerometry study |
| topic | Fatigue Physical activity Subarachnoid hemorrhage Ecological momentary assessment Accelerometry Rehabilitation |
| url | https://doi.org/10.1186/s12984-023-01241-5 |
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