Fatigue and sensory hypersensitivity are common and disabling post-stroke symptoms. While these symptoms are often reported together, quantitative data on their relationship –and its specificity to stroke– remain limited.

We investigated the co-occurrence of post-stroke fatigue and sensory hypersensitivity, as well as their associations with demographic and clinical factors in a cross-sectional study. Additionally, we used structural equation modelling to characterise the relationship between fatigue and sensory sensitivity and to assess its population specificity.

A total of 139 people with stroke, 91 people with orthopaedic injury, and 109 healthy adults completed the Fatigue in Daily Life Evaluation and the Multi-Modal Evaluation of Sensory Sensitivity.

Among stroke participants, 41% reported both fatigue and sensory hypersensitivity, 28% reported fatigue alone, and 8% reported hypersensitivity alone. Co-occurrence of fatigue and sensory hypersensitivity was not associated with demographic variables, medical history, stroke characteristics, or cognition. Stroke participants with both symptoms reported more severe fatigue than those with fatigue alone (Dunn test; holm-adjusted p value < 0.01). Across all groups, sensory sensitivity showed a strong association with mental fatigue, whereas physical fatigue emerged as a more distinct concept.

Post-stroke fatigue and sensory hypersensitivity are interrelated but distinct symptoms, with mental fatigue showing the strongest link to sensory sensitivity. The overlap between post-stroke fatigue and sensory hypersensitivity underscores the need for multidimensional assessment and individualized rehabilitation approaches. Further research is needed to clarify the causal directionality of this relationship.