Post-Stroke Motor Fatigability: Defining and Studying the Impairments That Emerge During Prolonged Motor Tasks.
Adarsh Mavathaveedu, Jennifer Paige Hepple, David A Cunningham and 1 others
PMID 41787254WHAT IT FOUND
Prolonged motor tasks after stroke often show greater endurance loss in paretic limbs, likely from reduced brain input to the muscle rather than the muscle itself.
Tests vary, so endurance time may be more informative than strength alone.
Key findings
01During sustained lower-limb tasks after stroke, paretic legs often show shorter endurance times, yet post-task maximum force declines are not significantly different from non-paretic or able-bodied legs.
02In paretic muscles, voluntary activation can fall by 10-20% during sustained tasks, while resting twitch declines are smaller on the paretic side, 20-40%, than on the non-paretic side, 40-60%.
03Direct tests can show performance decline but cannot conclusively identify its source, and the review recommends endurance time for comparing limbs.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
This is a narrative review, so it does not report a new trial or test whether an intervention improves patient outcomes. Most reviewed data are from chronic stroke, while acute and subacute post-stroke motor fatigability remain unclear. Different studies use different muscles, tasks, and outcome measures, so results are not directly comparable. Direct performance tests cannot conclusively show whether fatigability is central or peripheral without additional localization tests. EMG findings are inconsistent and have no agreed threshold for clinically meaningful differences. Severe weakness or paralysis may make prolonged motor testing impossible.
Declared interests
The authors declared no potential conflicts of interest for this article.
The easy way to misread this
Do not conclude that central fatigability is the proven cause of every patient's poor endurance. The review says performance fatigability has been reported across many but not all paradigms, and direct tests cannot conclusively identify central versus peripheral sources.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →