Project 461473

A stroke happens when blood flow to the brain is stopped and the brain gets damaged. At least half of people with a stroke have fatigue months and even years later. A lot of people report fatigue as one of the worst symptoms post stroke that can affect daily activities and the length and quality of life. Though we do not fully understand all the reasons for fatigue after stroke, or how to best treat it, we think that fatigue results from the stroke changing the brain, reducing physical fitness, and decreasing muscle strength. A stroke can also affect sleep and mood that can impact how people feel too. We also do not know why women experience more fatigue than men after a stroke. Some studies have tested a drug called Modafinil for post stroke fatigue, while other studies have tested exercise for it. Yet, there is unclear evidence for either treatment, so our study has two main aims: 1. Test if exercise is better than stretching 2. Test if Modafinil is better than a sugar pill As another aim, we will also look at if combining Modafinil with exercise has any benefits. Our study will take place at 8 Canadian research sites to give a good representation of people after a stroke. Each person will be tested on fatigue, mood, fitness, thinking skills, sleep, and usual activity levels. Everyone will be assigned at random (like flipping a coin) to 1 of 4 groups: 1. Sugar pill plus exercise 2. Sugar pill plus stretching 3. Modafinil plus exercise 4. Modafinil plus stretching The treatment will last 8 weeks. The Modafinil or sugar pill will be taken once a day. The exercise or stretching will be delivered virtually by a trained therapist over computer to people at home 3 times a week. We will measure change in fatigue, quality of life, and other measures over 6 months. We will assess the results to identify the best treatment for post stroke fatigue. We hope to be able to find a treatment that will help reduce fatigue and improve quality of life after a stroke.