Activity limitations and factors influencing functional outcome of patients with stroke following rehabilitation at a specialised facility in the Western Cape

C Joseph, A Rhoda

Abstract

Background: Determining the functional abilities and factors influencing outcome of patients with stroke following rehabilitation are essential for the planning of future interventions and services in order to optimise recovery.

Objectives: To determine the activity limitations and factors influencing functional outcome of patients with stroke managed at a specialised rehabilitation centre.

Methodology: A longitudinal study design was used to determine the functional outcomes of patients admitted to the centre on admission and discharge. A data gathering sheet was developed to collect information pertaining to the demographicand medical profile and process of rehabilitation, whereas the Barthel Index was used to collect data relating to functional abilities. For analysis, descriptive statistics as well as  inferential statistics (Student t test) were utilised to determine the paired
differences. Six prognostic factors influencing functional outcome were selected and tested using linear (bivariate) regression.

Results: The mean Barthel Index scores on admission and at discharge were 58.85 and 81.59 respectively. A significant improvement was noted in the execution of functional task of patients with stroke (p< 0.01) between the data collection points. Despite the significant overall improvement, results show a high prevalence of dependence with walking and stair climbing at discharge. Only functional ability on  admission (r=0.49) predicted a favourable functional outcome at  discharge.

Conclusion: This study highlights the limitations of younger stroke  survivors and the need for continued rehabilitation following in-patient care. It further underscores the administration of a functional rating scale on admission in order to aggressively manage activity limitations.

Key words: stroke, activity limitations, factors influencing outcome, ICF, rehabilitation