Date of Award

2014

Document Type

Scholarly Project

Degree Name

Master of Occupational Therapy (MOT)

Department

Occupational Therapy

First Advisor

Jan Stube

Keywords

Fatigue -- therapy; Stroke -- complications; Telemedicine -- utlization

Abstract

There is currently a lack of research on the effectiveness of energy conservation techniques to treat the fatigue experienced by individuals following a stroke. Because of this, the purpose of this research study was to explore the effects of Managing Fatigue: A Six Week Course for Energy Conservation, developed by occupational therapists, Packer, Brink, and Sauriol (1995), on the level of fatigue individuals experience following a stroke. As telehealth is an emerging area in occupational therapy service delivery, the present study also aimed to determine the effectiveness of occupational therapy services delivered via teleconference.

A pilot study using a pretest-posttest single subject design was implemented to obtain and analyze data from one participant. UND and Altru IRB approval were received and the participant gave informed consent. The participant completed the Managing Fatigue course over five consecutive sessions via teleconference with the principal investigators and their advisor. A self-developed demographic questionnaire and the Patient-Reported Outcomes Measurement Information System (PROMIS) Fatigue Short Form 7a were completed by the subject prior to completion of the Managing Fatigue course. Additionally, the Fatigue Impact Scale (FIS) and the Canadian Occupational Performance Measure (COPM) were utilized prior to and following participation in the Managing Fatigue course to analyze potential changes in fatigue severity and subject-perceived occupational performance. All assessments and delivery of the Managing Fatigue course were completed via teleconference.

The subject participating in this research was a 70 year old male who experienced a left-side ischemic stroke five years prior to the study. Following completion of the Managing Fatigue course, fatigue severity noted from the FIS decreased from 47 to 13 out of a possible 160 on the Fatigue Impact Scale (FIS), evidencing improved fatigue severity. Decreases in fatigue were noted in physical, cognitive, and social categories. The subject’s average perceived occupational performance score improved from 4.8 to 5.2 out of a possible 10 following participation in the Managing Fatigue course. Furthermore, his average satisfaction score increased from 4.2 to 5.0 out of a possible 10 in prioritized areas of occupation through the use of the COPM. This evidences increased subject-perceived occupational performance and satisfaction in areas of occupation of importance to the subject.

Although performance and satisfaction in occupational performance increased and fatigue severity decreased following participation in the Managing Fatigue course, it cannot be inferred that participation in the course was the cause of the change. Limitations of the research, including that it was a pilot study and utilized a single-subject sample size, result in a lack of generalization to a larger population and warrant future research with a larger sample to study the effectiveness of the Managing Fatigue course on post-stroke fatigue. Furthermore, the decrease in fatigue evidences a possible benefit of the use of teleconference service delivery. However, as changes in data from pretest to posttest were evident, future research is warranted to study the influence of telehealth with the post-stroke fatigue population.

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