Fatigue Flashcards
By what is ‘Pathological Fatigue’ characterized in contrast to ‘Non-pathological Fatigue’?
- greater intensity
- longer duration
- more disabling effects on functional activities
- remains after rest as a severe condition
What is Chronic Fatigue Syndrome? (CFS)
Persistent debilitating fatigue lasting for at least 6 months not due to ongoing exertion, not substantially relieved by rest, and not caused by other medical conditions
Name 3 ways in which fatigue can be conceptualized into two components
subjective feeling
vs
performance decrement
-> problem: poor correlation between these two
peripheral fatigue
vs
central fatigue
primary
vs
secondary
What is the difference between peripheral and central fatigue?
Peripheral fatigue = failure to sustain force or power output because of neuromuscular dysfunction outside of the CNS.
Central fatigue = resulting from failure to achieve and maintain the recruitment of high-threshold motor units, implicating dysfunction in the central nervous system
Fatigue is a multidimensional construct.
Name the 4 components of which fatigue is at least compromised of.
- behaviour (effects on performance)
- feeling (subjective experience)
- mechanism (physiological and psychological)
- context (e.g. environment)
Name the 4 primary involved brain mechanisms/regions included in fatigue
- basal ganglia
- frontal lobes
- HPA-axis
- proinflammatory cytokines affecting neural metabolism
DeLuca article: central fatigue may be the result of ‘‘failure in the integration of limbic input and motor functions within the basal ganglia affecting the striatal-thalamic-frontal cortical system’’
Name the definitions of primary and secondary fatigue
Primary fatigue = caused by its primary neural mechanisms (e.g. changes in basal ganglia activation during fatigue-producing activity)
Secondary fatigue = includes factors perpetuating or exacerbating its effects (e.g. deconditioning, sleep habits, medication) Closely linked to feelings of fatigue.
Name 4 characteristics on which (fatigue) questionnaires can differ
- number of items
- item content
- duration of fatigue (whether this is asked)
- time frame
Regarding to fatigue questionnaires, what are arguments of authors of focused scales and of authors of multidimensional scales?
Authors of focused scales: pure measures of fatigue are more homogenous (measuring only the core feelings of fatigue and excluding other aspects which might be better assessed by separate instruments)
Authors of multidimensional scales: including many factors is necessary to assess the complexity of fatigue
What could be an objectivey measurement of performance decrement? (to assess fatigue?)
Almost any behavioral or cognitive performance could conceivaby be assessed, including muscular conractions, eye blinking, overall motor activity and various cognitive tasks
What are 4 approaches for the objective measurement of cognitive fatigue?
- over an extended time
- during sustained mental effort
- after challenging mental exertion
- after challenging physical exertion
What are the avantages of fatigue questionnaires (5) and of objective measurement of performance decrement (1)?
Advantages of fatigue questionnaires:
- inexpensive
- readily available
- quickly administered
- require little staff training
- place few demands on seriously ill patients
Advantages of objective measurement of performance decrement
- provide objectively verifiable data
What are three ways to minimize the effect of fatigue on neuropsychological performance during assessments?
- shortening test sessions
- giving difficult tests early in a session
- allowing many rest periods
What can be a reason for the discrepancy between findings on fatigue between healthy individuals and clinical populations?
Studies on healthy participants and clinical studies may not measure the same thing:
- clinical studies examine the effect of fatigue on performance
- majority of non-clinical studies examine the effect of lack of sleep on performance
Name the 3 forms of intervention typically involved in treatment of fatigue
- psychotherapy
- pharmacotherapy
- physical exercise
