Lightning Oral Presentation Australian and New Zealand Stroke Organisation Conference 2026

Rethinking Fatigue: Acceptability, usability and preliminary effects of a novel psychoeducational intervention for post-stroke fatigue (139621)

Stewart Blackwell 1 2 , Coralie English 1 2 3 , Lorimer Moseley 4 , Julie Davey 5 , Saran Chamberlain 6 , David Flood 6 , Emily Ramage 7 8 , Gillian Mason 9 , Lucette Lanyon 10 11 , Avril Drummond 12 , Ellyn Riley 13 , Alicia Harris 14 , Alex Delbridge 15 , Camille Biemans 16 17 , Dawn Simpson 1 2
  1. School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, NSW, Australia
  2. Brain Health Program, Hunter Medical Research Institute, Newcastle, NSW, Australia
  3. Centre of Research Excellence to Accelerate Stroke Trial Innovation and Translation, University of Sydney, Sydney, NSW, Australia
  4. IIMPACT in Health, College of Health, Adelaide University, Kaurna Country, Adelaide, South Australia, Australia
  5. Stroke Lived Experience Partner, Melbourne, Victoria, Australia
  6. Stroke Lived Experience Partner, Adelaide, South Australia, Australia
  7. Stroke and Critical Care, The Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia
  8. Physiotherapy, Western Health, St Albans, Victoria, Australia
  9. Hunter Medical Research Institute, Newcastle, NSW, Australia
  10. School of Allied Health, Human Services & Sport, La Trobe University, Melbourne, Victoria, Australia
  11. Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Victoria, Australia
  12. Rehabilitation, Sport, Ex and Health Sci, Loughborough Uni, Loughborough, England
  13. Aphasia Lab, Department of Communication Sciences and Disorders, Syracuse University, Syracuse, NY, United States
  14. Neuro Alliance, Thornton, NSW, Australia
  15. School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Victoria, Australia
  16. Research Group Movement Behaviour for Secondary Prevention, Physiotherapy School of Health Sciences, Fontys University of Applied Sciences, Eindhoven, the Netherlands
  17. Department of Rehabilitation, Physiotherapy Science and Sport, University Medical Centre Utrecht Brain Centre, Utrecht, the Netherlands

Background: Post‑stroke fatigue is prevalent, debilitating and can persist for years, with currently no effective treatment available. We codesigned the psychoeducational ‘Rethinking Fatigue’ intervention. In this study, we aimed to evaluate intervention acceptability, usability and preliminary effectiveness.

Methods: We conducted a multiple-baseline single-case experimental design with community dwelling stroke survivors with fatigue. The study had 3 phases: (3-week baseline, 8-week intervention, 6-week follow-up). The intervention comprised 45-minute telehealth sessions (one/week) with a health professional, supplemented by a participant handbook. The primary outcome was fatigue assessed daily (0-10 VAS). Secondary outcomes (FSS‑7, EQ‑5D‑5L, Stroke Self‑Efficacy, NEADL, HADS, cognitive flexibility) were assessed at study inception, end baseline, end intervention, 6-week follow up. Qualitative interviews (Thematic Analysis) explored intervention acceptability, usability and perceived effects.

Results: All participants [n=9, median age 65 (IQR = 43-69) years, 67% female, mean time post-stroke 5.3 years) completed 100% of intervention sessions, rating the intervention as acceptable. Participants demonstrated a statistically significant reduction in fatigue VAS scores between baseline and follow-up (Tau-U = −0.34, 95% CI [−0.52, −0.16], p < 0.001) and improved quality of life (mean 0.06-point improvement EQ-5D). No other quantitative findings were significant. Qualitative findings highlighted changed understanding of fatigue including recognising fatigue as modifiable, improved metacognition through reflective learning cycles, and a transition to independent application of behaviour change strategies, resulting in reduced impact on daily life.

Conclusions: The Rethinking Fatigue intervention was acceptable, usable and indicated potential positive effects, supporting that testing in a larger controlled trial is warranted.