Activity limitations of patients with stroke attending out-patient facilities in the Western Cape, South Africa

Functioning at 6 months post stroke following discharge from inpatient rehabilitation

“…19 Thirty per cent of participants had a BI score of 100 at 6 months compared with 20% of stroke survivors in the CHCC cohort receiving less intensive rehabilitation. 7 Moreover, the median BI of 90 at 6 months in our study is similar to European stroke units in the CERISE study (median range 85 -100). 20 However, differences in age and severity profiles between cohorts are likely to complicate comparisons.…”

“…Outcome measures in terms of stroke disability were: ADL independence according to the Barthel index (BI); 11 abilities for community living according to the Nottingham extended activities of daily living (NEADL) scale; 7,9,12 and global disability according to the Modified Rankin Scale (MRS) structured interview. 13,14 Responses to individual questions on the MRS structured interview were used to describe perceived changes in usual duties and activities -including work, family responsibilities, social and leisure activities -and relationships with family and friends.…”

“…6 Patients receiving rehabilitation at community healthcare centres (CHCC) in the Western Cape experienced problems with extended activities of daily living (ADL) and community integration. 7 These studies refer to stroke cohorts receiving little rehabilitation input. There are few data on the outcomes of patients who are able to access intensive inpatient rehabilitation in SA.…”

Impact of post-stroke impairments on activities and participation as experienced by stroke survivors in a Western Cape setting

“…Study participants experienced activity limitations as indicated by the mean SIS-3 ADL score of 49.1 and a mean MBI score of 70.58 (Table III 10,11,12 attributed activity limitations to poor physical function and decreased muscle strength, while Rhoda et al 5 did not discuss possible causes. Findings from the current study showed, through statistical analysis, that muscle strength and function did indeed affect the ability to perform activities.…”

“…As concluded by Hoffmann et al in a Chochrane review: "The effectiveness of occupational therapy for cognitive impairment post-stroke remains unclear" 32:2 . An activity that can severely limit participation in South Africa is mobility both in the home and the community 5,10,11 . In the current study various factors could have contributed to participants not achieving community mobility.…”