day and getting up at the same time
Ways to assist in managing
fatigue
• Balance activity and rest
• Use energy saving techniques
throughout the day (i.e. complete
activities sitting down)
• Alternate between mental and
physical activity
• Get to know your triggers to fatigue
• Get to know your energy limits on
different activities
• Work within your energy limits, don’t
wait until you feel you have gone too
far
• Pace activities throughout the week
• If necessary only tackle one larger
activity a day
• Take regular rest breaks, if requiring
sleep during the day try to have 30
minute ‘power naps’ and avoid
sleeping after 4pm
• Try
to exercise
regularly
If you
require any
furtherwithin
information or
physical
capability
advice please
contact the
Gloucestershire Brain Injury Team on
422 5139
If0300
you require
any further information or
advice please contact the
Information for this
leaflet
has
beenon
Gloucestershire
Brain
Injury
Team
adapted
0300
422from
5139the following references
which may provide useful further reading.
Information for this leaflet has been
Cooper, from
J. Malley,
D (2008)references
Managing
adapted
the following
fatiguemay
after
brain injury,
– the
which
provide
useful Headway
further reading.
brain injury association. Russell Press
Ltd, Nottingham.
Cooper,
J. Malley, D (2008) Managing
fatigue after brain injury, Headway – the
Powell,
T (2004)
Head Injury:
practical
brain
injury
association.
RussellA Press
guide,
Speechmark Publishing Ltd,
Ltd,
Nottingham.
Bichester.
Powell,
T (2004) Head Injury: A practical
guide, Speechmark Publishing Ltd,
Bichester.
• Prioritise where to use your energy
• Try to ensure at least eight hours
sleep a night to assist energy levels
for the next day
• Try to establish a regular routine by
going to bed at the same time each
day and getting up at the same time
• Try to exercise regularly within
physical capability
GHPI0871_01_13
Author: Nicola Mifflin
Review due: March 2016
www.gloshospitals.nhs.uk
GHPI0871_01_13
Author: Nicola Mifflin
Review due: March 2016
www.gloshospitals.nhs.uk
Managing Fatigue
after
Brain Injury
BETTER FOR YOU
What is fatigue?
Triggers to fatigue
The purpose of this leaflet is to give
information and advice on how to
manage the effects of fatigue after a brain
injury. Fatigue is experienced by
everyone at some point after a period of
physical or mental activity and is a signal
telling us to take a break. Tiredness, loss
of physical stamina and fatigue after brain
injury are some of the most persisting
symptoms because they affect everything
that a person does and unlike ‘normal’
fatigue these symptoms are not always
improved with rest.
Activities which trigger fatigue will be
different for everyone. Examples include:-
Causes of fatigue after
brain injury
There have been various ideas put
forward for the causes of fatigue. One
such idea is that the part of the brain, the
brain stem which controls consciousness,
wakefulness and the rhythm of sleeping
has been damaged (Powell, 2004)
Another cause of fatigue post brain injury
which has been suggested is that
inflammation of the nerves in the brain
which occur following brain injury can
disrupt information processing and
memory. If these skills are affected then
greater effort is required in all mental and
physical tasks leading to increased levels
of fatigue.
Whatever the cause it is clear that fatigue
is a major factor for people post brain
injury.
• Working at a computer
• Going for a walk
• Being in a busy environment such as
a shopping centre or restaurant
• Going to the gym
Managing fatigue
For some people fatigue improves over
time. However for many people fatigue is
a condition that they have to learn to
manage in the long term. Often there is a
tendency to try and return to the same
levels of activity that were achieved prior
to a brain injury, which can lead to a
‘vicious cycle’ of good and bad days (as
illustrated on the following graph).
Bad days – When people have bad days
the tendency is to rest to ‘recover’
however doing very little for a few days
leads to decreased fitness and motivation.
Good days – When people do feel better
the temptation is to do all of the things left
undone during bad days. However this
can lead to over-activity. As fitness is
reduced, people quickly feel worse and
need to rest again.
Pacing
Evidence from research has shown that
people can often get back to doing almost
everything they want to do using a
method called pacing.
Pacing means keeping to the same
amount of activity each day whether
having a good or bad day. If everyday
activities can be successfully paced using
a ‘little and often’ approach then fitness
will improve over time.
Prioritising
When pacing activities it is also important
to prioritise what is most important. This
involves thinking about all of the activities
that have to be done each day/week and
considering the following:
• Which jobs are most important or
essential?
• Which activities are most enjoyed?
• Which tasks could be delegated to
someone else?
• Could any activities be done less often
or eliminated altogether?
(Cooper and Malley 2008)