Trajectories of fatigue and related outcomes following mild acquired brain injury: a multivariate latent class growth analysis.
Tom Smejka, Daan Verberne, Jan Schepers and 4 others
PMID 38506428WHAT IT FOUND
After mild brain injury, 53% had mild, decreasing fatigue and no other problems. 29% had persistent fatigue, cognitive complaints and low participation satisfaction. 11% had persistent fatigue with mood and cognitive complaints. 7% had improving fatigue with mood problems.
Key findings
0153% of participants were in a class with initial fatigue below the clinical cut-off, no clinically significant anxiety or depression, and fewer cognitive complaints than classes 2 and 3.
0229% of participants were in a class with persistent clinically significant fatigue, no mood problems, persistent cognitive complaints and satisfaction that remained below the average for this population.
03Female participants and older participants were more likely to be in the class with persistent fatigue and primarily cognitive problems.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
This was an observational study, so it cannot show that fatigue caused other problems or that any treatment changed the trajectories. The study did not know what treatments each class received or when they received them, so class differences cannot be linked to care. Only mild traumatic brain injury and minor stroke were analysed, so the results may not apply to more severe brain injury. Fatigue was measured as overall severity, not as physical, mental or emotional fatigue, so the type of fatigue cannot be identified. Of 316 recruited, 91 were excluded for not meeting mild acquired brain injury criteria, 18 dropped out and 3 died. The final analysis included 204 participants. The injury groups were unbalanced, with 159 participants having mild traumatic brain injury and 45 having minor stroke, so injury-type class differences may reflect group sizes.
Declared interests
The study was supported by grants from the Netherlands Organisation for Health Research and Development and the Brain Foundation. The authors declared no competing interests.
The easy way to misread this
Do not read the four classes as proof that fatigue causes cognitive and participation problems or that early treatment improved outcomes. The study observed patterns over time, did not record treatments, and cannot show causal effects.