This document discusses fatigue, including its definition, types, causes, symptoms, and assessment. It defines fatigue as tiredness or diminished energy that interferes with normal activities. Fatigue can be acute or chronic, and local or general. Common causes include lack of sleep, stress, illness, and advancing age. Symptoms include forgetfulness and lack of interest. Assessment involves history, physical exam, and potentially blood tests and imaging. Tests evaluate things like anaerobic capacity, aerobic capacity, and muscle strength and fatigue. Questionnaires can also assess fatigue severity.

1. PRESENTED BY : JWANIKA VANSIYA

2.  Fatigue is defined as the subjective complain of
tiredness or diminished energy level to the point
of interfering with normal or usual activities.
 Fatigue can be menifested as difficulty or
inability initiating activity ( perception of
generalized weakness) reduced capacity
maintaining activity and difficulty with
concentration , memory and emotional stability.

3. Acute
fatigue
Chronic
fatigue
1 Local
fatigue
General
fatigue
2

4.  Lack of sleep
 Long work hours
 Shift rotation
 Noise
 Boring work
 Too much stress
 Alcohol
 Drugs
 Worries
 Illness
 Advancing age

5. .
Heart
failure
.
COPD
Multiple
sclerosis
.
Myesthenia
gravis
All types of
infections.
anemia

6.  Forgetfulness
 Poor communication
 Impaired decision-making skills
 Lack of alertness
 Slow reaction time
 Quick of anger
 No sense of humor
 Lack of interest
 Always tired

7. history
Physical examination
Laboratory studies

8.  ID : Age, Gender, Nationality, Occupation
 Chief complain
 Onset : abrupt or gradual, related to event or
illness
 Course : stable, improving or worsening?
 Factors that alleviate or exacerbate symptoms
 Impact on daily life- ability to work

9. Medical
history
Family
history
Drug
history
Social
history
Allergy
history

10.  When the fatigue is started, how long it lasts,
and what makes it better or worse?
 Symptoms or side effects, such as pain, the
patient having from the cancer or the
treatments.
 Medicines being taken.
 Sleeping and resting habits.
 Eating habits and changes in appetite or
weight.
 Whether the patient has depression, anxiety

11.  Health habits and past illnesses and
treatments.
 How the fatigue affects being able to work.

12.  General appearance
 Posture
 patient’s walking
 Trouble breathing or loss of muscle strength
 Palpation
 Analogue scale: describes the fatigue on a
scale 1 to 10
1 5 10

13.  Anemia: pallor, tachycardia, systolic ejection
murmur
 Goitre or thyroid nodule: dry skin, delayed
deep tendon reflexes, peri orbital puffiness,
 Hyperthyroidism: weight loss, hyper reflexia,
fine tremor, atrial fibrillation.
 Addison’s disease: hypotension, scar,
pigmentation in skin creases
 Heart failure: elevated jugular venous
pressure, ankle edema

14. Systemic
assessment Local
assessment

15. Anaerobic fatigue:
 Assessment of the fatigue during anaerobic
power performance when vigorous exercises
continues for more than few seconds .
 Anaerobic fatigue is the percentage decline in
the power output during the test.

16.  The various tests which are used for
anaerobic fatigue are following:
Katch test
Wingate cycle
ergometer test
Measurement of
blood lactate level

18.  Procedure
 Test scores:
• Peak power output = force * distance
(num of revolutions*distance per revolution
divided by time in minutes)(5secs=o.o83min)
• Anaerobic fatigue=high power output – low power
output divided by high power output* 100

19.  if a man weighing 73.3 kg performs wingate test
on a Monark cycle ergometer (6.0 m traveled per
pedal revolution) with an applied resistance of
5.5kg (73.3*0.075=5.49 rounded off to 5.5kg),
pedal revolution at 5 secs interval is 12,10,8,7,6,5
(48 total revolution in 30 seconds)
 Peak power output= force*distance divided by time
5.5kg*(12*6)divided by 0.083 min
4753kg.m/min or 776.8 watts

20.  Anaerobic fatigue=high power output-low power output
divided by high power output * 100
High power output is 776.8 W
Low power output= force*distance divided
by time
5.5 * (5*6) divided by 0.083
1980.8 kg.m/min = 323.7 W
Anaerobic fatigue = 776.8-323.7 divided by 776.8*100=58.3%

21.  Fatigue is reached the amount of lactate in
the muscle and blood is maximum.
 Measurement of lactate in blood can give an
idea regarding the extent of fatigue.

22. Measurement of aerobic capacity
• vo2 max = co * arteriovenous o2 diffrence
• Arteriovenous o2=arterial o2- venous o2
Measurement of energy expanditure
• Spirometry testing

23.  Assessment procedure which indicate a fall in
the strength or firing ability of the muscle
fiber can be used to determine fatigue.
Decremental
studies
EMG
MMT

24.  Brief fatigue inventory
 Fatigue severity scale
 Piper fatigue inventory

26.  Depending on the findings in the history and
physical examination, blood tests and other
imagine studies may be ordered.
 CBC (complete blood count)
 Blood sugar
 TSH
 Tests for deficiency in vitamin B12, D,folic
acid and iron
 ESR

27. 1. Exercise physiology. McArdle, Katch and
Katch
2. Physiology of sport and exercise. Jack H.
wilmore, W. Lany Kenney.
3. Physiotherapy in neuro-condition. Glady