Patients who receive antispasmodics through an intrathecal route via an implanted pump often experience better spasticity control without the accompanying sedation. 9 Fatigue typically increases during exacerbations of RA and decreases during periods of remission. The three factors most likely to influence RA fatigue are the extent of disease activity, disturbed sleep, and increased physical effort. 13 More than 70 percent of patients with PPS report that fatigue has had a negative impact on their ADLs. 7 PPS fatigue most often occurs toward the end of a period of activity, such as late morning or early evening.
Patients describe the fatigue as a sudden loss of physical, mental, and emotional energy.
14 Researchers report that fatigue increases over the course of radiation therapy and gradually diminishes once treatment is over. Only a few studies have looked at the pattern of fatigue and chemotherapy. They show that fatigue is highest one to two weeks following chemotherapy and then gradually improves, only to recur after the next dose of chemotherapy. 14 Complete relief from fatigue may not be possible for patients who are undergoing cancer treatment, but nurses can suggest interventions that will minimize the impact. Surprisingly, the study showed that the most frequently used strategies, including those often suggested by healthcare professionals, were not necessarily effective in modifying fatigue.