| Summary: | MSc Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand === Background and purpose of the study
The length of stay for patients with stroke in some South African government
hospitals has been shown to be inadequate and there is little information on
the physical impairments and functional abilities of this population once they
return to the community. An assessment was done of the strength, range of
movement and the presence of pain experienced by patients with stroke in the
Daveyton community and the relationship between these impairments and the
functional abilities of these patients was established.
Research methods and procedures employed
This was a quantitative study using a descriptive cross sectional study design.
Thirty-four conveniently sampled patients with stroke were assessed in their
Daveyton homes. The functional measures used were the Modified rivermead
mobility index (MRMI) and Barthel index (BI). The strength was assessed
using a hand-held dynamometer, range of movement (RoM) with a standard
universal goniometer and pain with the Eleven faces pain scale. The
significance of the study was set at 0.05 and the relationships between
impairments and functional abilities were expressed using the Spearman’s
rank correlation coefficient.
Results
Significant differences were found between the strength, as well as the RoM
of the affected and unaffected sides (p < 0.05). The muscles most affected by
were: Biceps, Gastrocnemius and Tibialis Anterior. The smallest strength
difference was found in Gluteus maximus. The ranges of movement most
affected were: shoulder flexion and elbow extension. The smallest difference
was found in knee extension. Eighty-five percent of the sample attained
scores indicating that they were independently mobile (measured by the
MRMI), and 82% were independent in activities of daily living (measured by
the BI). There were good correlations between the patients’ strength
impairments and their functional abilities (r = 0.54 to 0.79) and mobility (r =
0.51 to 0.76). Functional abilities and mobility had moderate to good
relationships with active range of movement of shoulder flexion, lateral
shoulder rotation and dorsiflexion. The percentage of patients experiencing
pain was 73%, but pain displayed no relationship with functional ability (r =
0.14) and mobility (r = 0.15).
Conclusion
Most people living with stroke in the Daveyton community are functionally
independent despite the high prevalence of pain. Stroke results in significant
strength and active range of movement deficits on the affected side. Most
strength impairments correlated well with the functional ability and mobility of
this sample, but active range of movement impairments that influenced
functional measures were mainly shoulder and ankle movements.
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