A clinical reasoning framework for fatigue for neurologic physical therapy

Background: Fatigue is a common but poorly understood phenomenon frequently seen in patients with neurologic diagnoses. The impact of fatigue on mobility in these patients can be significant, indicating that it can have a large effect on physical therapy management. There is little literature available to Physical Therapists to guide them toward appropriate strategies for examination, evaluation and management of patients with neurologic pathologies who present with limitations due to fatigue. Objectives: (1) To present clear definitions describing the subjective and objective components of fatigue and the impact they might have on mobility in patients with neurologic conditions; (2) To present a clinical reasoning framework that clinicians can utilize to examine, evaluate and treat fatigue in patients with neurologic conditions; (3) To provide examples of how the framework can be applied in clinical practice. Conclusions: Fatigue is common in patients with neurologic disorders and can impact physical therapy management. The clinical reasoning framework presented here can help clinicians provide appropriate examination, evaluation and treatment for use with patients with neurologic pathologies.