Motor and functional recovery after stroke: a comparison between rehabilitation settings in a developed versus a developing country

Abstract

BackgroundRecovery post stroke is well documented in the field of stroke rehabilitation. The structure and process of rehabilitation are different between developed and developing countries. The aim of the present study was to compare the motor and functional recovery of stroke patients in Germany versus stroke patients receiving rehabilitation in South Africa.MethodsThis study used secondary data analysis of patient protocols collected in two independent studies conducted in Germany and South Africa respectively. A total of 73 patients from the two separate studies were matched for age at stroke onset, gender, and initial motor functioning. Motor and functional recovery were assessed at baseline, two and six months post stroke using the Rivermead Motor Assessment Scale and the Barthel Index (BI) respectively. Significant differences in motor and functional recovery were found, using the Wilcoxon rank sum test on admission to the centre, and at two and six months after stroke. A generalized linear mixed-methods model (GLIMMIX) was used to compare the recovery patterns between the participants from the two settings over time.ResultsThe results of the GLIMMIX revealed a significant difference in favour of the German participants for gross motor (RMA-GF) and upper limb (RMA-A) recovery, while no significant difference was found for lower limb (RMA-LT) and functional (BI) recovery patterns between the participants of the two settings. No significant differences existed in RMA-A and BI-scores on admission to the CHC/SRU. At two and six months after stroke, both the RMA-A and BI-scores were significantly lower in the South African than the German sample.ConclusionThe results of this study provide empirical evidence for differential recovery patterns for patients in developed and developing countries. A detailed exploration of the factors to which this difference in recovery patterns can be attributed was beyond the scope of the present study, and is recommended for future research.

Surviving stroke in an Ebola Treatment Centre

“…This was difficult to maintain with the human resources available and within the constraints of the personal protective equipment (PPE) 5. Risks of a breach in the PPE were higher when dealing with a partially immobile patient.…”

Accelerometry: A feasible method to monitor physical activity during sub-acute rehabilitation of persons with stroke

“…However, little is known about PA behaviour earlier on after stroke when most recovery of motor functioning occurs (18,19). Previous studies investigating PA in the acute and sub-acute phases report sedentary behaviour as a problematic area in need of remediation (20,21).…”

Ocena Czynników Ryzyka Występowania Bólów Okolicy lędźwiowo-Krzyżowej u Nastolatków w Wieku 11-14 Lat

“…Jej wybór podyktowany był ścisłą korelacją pomiędzy mobilnością funkcjonalną, a poziomem jakości życia. A. Rhoda przeprowadziła dzięki niej ciekawą analizę porównawczą wyników pracy rehabilitacji w ośrodkach kraju rozwijające-go się i już rozwiniętego [8]. Chorych oceniano na początku i po dwóch miesiącach według trzech części składowych RMA czyli "Funkcji Globalnych", "Kończyny Dolnej i Tułowia" i "Ręki".…”

“…Dla grupy ze starego kontynentu pierwsze wyniki to 8 (4-11), 5 (3-7) i 4 (1-9). Dwa miesiące przyniosły poprawę zwiększając punktację odpowiednio do 11 (6-11), 7 (3-8) i 8 (2)(3)(4)(5)(6)(7)(8)(9)(10)(11). Uczestnicy programu z RPA zaczynali od 8 (4-10), 7 (5-8) i 6 (1-10) z wynikiem końcowym 10 (6-11), 9 (7-9) i 9 (3-14).…”

“…Uczestnicy programu z RPA zaczynali od 8 (4-10), 7 (5-8) i 6 (1-10) z wynikiem końcowym 10 (6-11), 9 (7-9) i 9 (3-14). W niniejszej pracy mediany wynosiły przed 5 (2,25-9,75), 7 (3,25-9) i 2 (0-9,5) i po zaledwie 21 dniach 11 (7)(8)(9)(10)(11)(12), 9 (7-10) i 4 (1-14,75). Założenie homogeniczności wszystkich wyżej omawianych pacjentów pozwoliłoby wysnuć wniosek, że skuteczność rodzimej rehabilitacji jest bliższa standardom zachodnim [8].…”