Impact of post-stroke impairments on activities and participation as experienced by stroke survivors in a Western Cape setting

Abstract

INTRODUCTION: This paper explores causal connections between impairments, activity limitations and participation restrictions after stroke. Understanding the impact of impairment on activities and participation can assist with determining optimal interventions. METHODS: The study population (N=267) of this descriptive study were public health care users, from the eastern sub-district of the Western Cape Metropole, who had had a stroke in 2009 or 2010. Fifty-three study participants were selected through stratified, proportional, random sampling. Data were collected using the Stroke Impact Scale-3.0 (SIS); the Modified Barthel Index (MBI); the Loewenstein Occupational Therapy Cognitive Assessment and a language screening test. Linear regressions to determine if impairments could be correlated with activity limitations and participation restrictions were done with Spearman rank correlations. T-tests were used to determine if impairments had any statistically significant impact on activities and participation. RESULTS: The mean SIS participation score was 31.3/100. Participation as measured by the SIS showed positive correlations with, and was impacted signifcantly by limb strength (r=0.49; p<0.01), visual perception (r=0.57; p<0.01), spatial perception (r=0.31; p=0.02), motor praxis (r=0.58; p<0.01), visuomotor organisation (r=0.50; p<0.01), and thinking operations (r=0.6l; p<0.01). The mean MBI score was 70.58/l00. MBI scores showed postive correlations with, and were impacted signifcantly by limb strength (r=0.78; p<0.01), hand function (r=0.65; p<0.01), visual perception (r=0.45; p<0.01), motor praxis (r=0.43; p<0.01), visuomotor organisation (r=0.48; p<0.01), and thinking operations (r=0.56; p<0.01). CONCLUSION: Motor, cognitive and perceptual impairments impacted activities and participation negatively. These impairments must be diagnosed and optimally managed. Key words: Stroke, cognition, perception, activities, participation