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Background: Reduced walking speed because of a stroke may limit activities of daily living (ADLs) and restrict social participation.Objectives: To describe the level of balance impairment, activity limitations, and participation restrictions and to investigate their relationship with walking speed in Burundians with chronic stroke.Methods: This cross-sectional study involved adult stroke survivors. Walking speed, balance, ADLs and social participation were assessed with the 10-meter walk test (10 mWT), the Berg balance scale (BBS), the activity limitation stroke scale and the participation measurement scale, respectively. In order to determine ambulatory independence status, participants were stratified into three walking speed groups (household ambulation, limited ambulation and full-community ambulation), based on the Perry classification.Results: Fifty-eight adults (mean age 52.1 ± 11.4 years) with chronic stroke were included in our study. Most participants had severe balance impairments (median BBS score, 27). Their mean (± standard deviation [SD]) walking speeds, ADL levels and social participation levels were 0.68 ± 0.34 m/s, 50.8% ± 9.3% and 52.8% ± 8.6%, respectively. Walking speed correlated moderately with balance (rho = 0.5, p  0.001) and strongly with ADL level (r = 0.7, p  0.001) but not with participation level (r = 0.2, p = 0.25).Conclusion: Using socio-culturally suitable tools, our study showed that walking speed correlates robustly with balance and ADL ability, but not with social participation, in Burundi, a low-income country.Clinical implications: Exercises targeting walking speed would be very useful for people with chronic stroke living in low-resource countries, in order to promote their functional independence.

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Background and purpose To determine the efficacy of the ACTIVLIM-Stroke questionnaire in detecting changes in functional status of stroke patients. Method Sixty-eight Benin and Belgian stroke patients participated in this 2-month longitudinal study, involving baseline and follow-up assessments. Outcome measures combined ACTIVLIM-Stroke questionnaire, Barthel Index (BI), 6-minute-walk test (6MWT) and modified Rankin scale (MRS). Responsiveness of ACTIVLIM-Stroke was investigated through different methodological approaches and compared with BI, 6MWT and MRS. Statistical analyses were performed using the paired t tests, effect size (ES) and correlation tests. Results ACTIVLIM-Stroke detected changes in the whole sample ( p<0.001, ES=0.78) and even in a subgroup of patients ( p<0.001, ES=0.29) that were classified as stable according to the MRS. Moreover, ACTIVLIM-Stroke permitted the classification of patients into more discriminative groups, including those showing an important improvement ( p<0.001, ES=1.87), a slight but non-clinically meaningful improvement ( p<0.001, ES=0.38), and no improvement ( p=0.1, ES=0.11), demonstrating its high sensitivity to change. Furthermore, there were concordant relationships between ACTIVLIM-Stroke change and any observed changes in BI, 6MWT and MRS scores (r≥0.50, p<0.001), confirming the external responsiveness of ACTVLIM-Stroke. Conclusions ACTIVLIM-Stroke showed good responsiveness and can detect accurately clinical changes in the functional status of stroke patients. The BI and the 6MWT were also responsive and may provide complementary information while investigating change in functional status. However, in addition to being highly sensitive to change, ACTIVLIM-Stroke presents significant methodological advantages for quantifying functional changes in stroke patients.

Background: Chronic low back pain (CLBP) is an increasing burden worldwide. The biopsychosocial factors associated with CLBP-related activity limitations have not yet been investigated in Burundi.Objective: The aim of our study was to investigate the biopsychosocial factors that influence the CLBP-related activity limitations in a Burundian sample population.Method: We carried out a cross-sectional study of 58 adults with nonspecific CLBP from Bujumbura city. Univariate and bivariate analyses were used to investigate the association between biopsychosocial factors and CLBP activity limitations. Sequential multiple regression analyses were subsequently used to predict CLBP activity limitations.Results: Fifty-eight individuals with a mean age of 41.3 ± 10.20, 58.6% of female gender, were recruited. The univariate and bivariate analyses demonstrated that educational level, gender, healthcare coverage, profession, height, pain intensity, depression and physical fitness were significantly associated with CLBP-related activity limitations (p range, 0.001 to 0.05). The multivariate regression analysis showed that the significant biopsychosocial factors accounted for 49% of the variance in self-reported activity limitations. Predictors of activity limitations were education level (β = −0.369; p = 0.001), abdominal muscle endurance (β = −0.339; p = 0.002) and depression (β = 0.289; p = 0.011).Conclusions: Our study provides evidence of biopsychosocial factor associations with CLBP-related activity limitations in Burundi. Evidence-based management and prevention of CLBP in Burundi should incorporate a biopsychosocial model.Clinical implications: Biopsychosocial factors should be regularly evaluated in people with chronic low back pain and efforts to improve the burden of chronic low back pain in Burundi should take these factors into account.

Background and purpose: Chronic low back pain (CLBP) is an increasing burden worldwide. The biopsychosocial factors associated with CLBP have not yet been investigated in Burundi. The aim of this study was to investigate the biopsychosocial factors that influence the CLBP-related outcomes of self-reported pain intensity, limitations in activities of daily living (ADLs), and social participation (SP) restrictions in a Burundian sample population.Methods: We carried out a cross-sectional study of 58 adults with non-specific CLBP from Bujumbura city. Measures of pain intensity, ADL limitations, SP restrictions, and biopsychosocial factors were analyzed with descriptive, inferential, and correlational statistics.Results: The biopsychosocial factors found to be associated with CLBP outcomes were body mass index (BMI), education level, gender, healthcare coverage, depression, trunk muscles endurance, and perceived exertion. Self-reported pain intensity was found to be significantly associated with a sub-university education level, depressiveness, high perceived exertion, low spine extensor muscles endurance, and low abdominal muscles endurance (p range, <0.001 to <0.05). Greater disability, in terms of ADL limitations and SP restrictions, was associated with sub-university education level, female gender, lack of healthcare coverage, high BMI, depressiveness, low spine extensor muscles endurance, and low abdominal muscles endurance, and high perceived exertion (p range, <0.001 to <0.05). Conclusions: This study provides evidence of biopsychosocial factor associations with CLBP-related pain, ADL limitations, and SP restrictions in Burundi. Significantly associated factors were consistent with factors that have been associated with CLBP outcomes in high-income countries, with the addition of lack of healthcare coverage as a significant factor in Burundi. Evidence-based management of CLBP in Burundi should incorporate a biopsychosocial model.