The effect of fatigue on the level of participation in a physiotherapy program of elderly acute stroke patients. Ferdi Başkurt 1 , Zeliha Başkurt 1* , Ayla Günal 2 1 Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Süleyman Demirel Üniversity, Isparta, Turkey 2 Department of Physical Therapy and Rehabilitation, Faculty of Health Sciences, Gaziosmanpaşa University, Tokat, Turkey Abstract Aim: The aim of this study was to investigate the effect of fatigue on the level of participation in a physiotherapy program of elderly acute stroke patients. Methods: The study included a total of 50 acute stroke patients aged ≥ 65 years (32 females and 18 males with a mean age of 75.14 ± 6.25 years). The level of functional independence of the patients was evaluated before the treatment program and on the day of discharge using the Functional Independence Measure (FIM) and the difference between the two FIM values was calculated to provide the delta-FIM value. Following each treatment session, the level of participation in the physiotherapy program was evaluated with the Pittsburgh Rehabilitation Participation Scale and the level of fatigue with the Barrow Neurological Institute Fatigue Scale, and mean points were calculated for these scales. Results: The mean points of the Barrow Neurological Institute Fatigue Scale were 28.58 ± 16.57 and the mean points of Item 11 of the same scale were 5.57 ± 2.75. The mean delta-FIM value was determined as 12.7 ± 17.98 and the mean Pittsburgh Rehabilitation Participation Scale points were 4.46 ± 1.00. A statistically significant negative correlation was determined between the Pittsburgh Rehabilitation Participation Scale and the Barrow Neurological Institute Fatigue Scale (r: -0.338, p<0.05). No statistically significant relationship was determined between the Pittsburgh Rehabilitation Participation Scale and the Functional Independence Measure (p>0.05). Conclusions: The results of the study determined that elderly acute stroke patients with a high level of fatigue had low levels of participation in the physiotherapy program. Keywords: Stroke, Elderly, Fatigue, Participation, Physiotherapy. Accepted on December 13, 2017 Introduction According to the World Health Organisation (WHO), stroke is a clinical syndrome characterised by symptoms of focal cerebral function loss and the level of the findings, with no apparent cause other than vascular [1]. Following a stroke, a series of problems may be experienced involving sensory, motor and cognitive functions and psychosocial functions [2,3]. Fatigue is a frequently seen and persistent symptom after stroke [4]. Studies on this subject have reported the prevalence of fatigue to be 23%-75% after stroke [5]. As fatigue is related to physical and mental energy loss, rehabilitation studies are oriented to the difficulties experienced and the impaired function loss of the patient [6]. In the first 3 months after stroke, patients have been shown to have complaints of higher levels of fatigue compared to healthy individuals of the same age and gender [7]. It has been reported that patients who feel they have completely recovered have a tendency to show fatigue compared to those who have completely recovered [8]. Fatigue in elderly stroke patients has greater negative effects on recovery and these effects last longer [6]. Fatigue in stroke patients is thought to be related to several factors [9]. It is known that this can be the result of reduced energy capacity, the need for increased energy when walking, the level of disability, sleep problems, nutrition, comorbidities, medications and psychological factors [10]. With reduced participation in activity in patients with a high level of fatigue, limitations are defined as the level of difference in daily living activities which are affected in a 1- year period [11-14]. Consequently, patients become dependent in both basic and assisted daily living activities [6]. Fatigue can be limited by a physiotherapy program and this can affect the rehabilitation process and the regaining of functions lost after a stroke [6,15]. Fatigue seen in the acute phase affects full participation in rehabilitation and in the long term (18 months), physical health ISSN 0970-938X www.biomedres.info Biomed Res 2017 Volume 28 Issue 20 9121 Biomedical Research 2017; 28 (20): 9121-9126