Upper limb mobility and personal management in patients with stroke attending occupational therapy at a tertiary hospital in Gauteng

Abstract

Key words: stroke; upper limb motor recovery; personal management Zukiswa Msengana, BSc OT (UWC); MSc OT (Wits) http://orcid.org/0000-0001-7302-8088 Senior Occupational Therapist, Baragwanath Hospital, Johannesburg Postgraduate student. Department of Occupational Therapy, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand Patricia De Witt, Nat. Dip. OT (Pretoria); MSc OT (Wits); PhD (Wits) http://orcid.org/Antonette Owen, BOT (UP), MSc OT (Wits) http://orcid.org/0000-0002-4573-4185Introduction: This study described the outcomes for upper limb motor function after stroke and personal management of patients attending occupational therapy at a tertiary hospital in Gauteng, up to two months' post-discharge.Methodology: A quantitative, descriptive correlation design used assessments of upper limb motor function and independence in personal management to collect the data. Forty-five participants received routine rehabilitation including occupational therapy at the hospital. The same measurements were administered on discharge and during out-patient follow up at one and two months.Results: Results indicated that of 45 participants only 33 were available for reassessment at discharge. These participants had significant improvement in upper limb motor function and personal management. At discharge 48% of participants had >80% recovery of upper limb function and 59% had achieved independence or modified independence in personal management. The correlation between upper limb function and 73% personal management at discharge was strong, indicating an association between return of upper limb function and independence in personal management. By two months post discharge the correlation between the variables was low, as while only 20% of the 15 participants who returned for therapy at month 2 were dependent for personal management and over 50% presented with no or poor upper limb function.Discussion and Conclusion: Rehabilitation including occupational therapy intervention contributed to participant's improved performance in personal management tasks, even when upper limb motor function recovery was suboptimal. The intervention for personal management and compensatory techniques taught to participants resulted in independent or modified independence two months after discharge.

The relationship between upper limb function and activities of daily living without the effects of lower limb function: A cross-sectional study

“…The toileting item assesses the degree of independence when putting on and taking off clothes worn on the lower half of the body and wiping the buttocks (Hamilton and Granger, 1994). The present study showed similar results to those reported by Msengana et al (2019), who showed that the South African Data Functional Medicine (SADFM) Beta Scale ® 37 toilet items were positively correlated with FMA-UL (r = 0.75, p < 0.05). The SADFM was an outcome measure standardized in South Africa to assess independence in the personal management of patients with disability and suggests that the recovery of the upper limb is important for the independence of toilet movement after discharge from the hospital.…”