Stroke Management and Rehabilitation in a Western Cape Province setting

Abstract

Introduction: Long-term disability caused by stroke can be decreased through comprehensive rehabilitation.
Aim: This article aims to describe the functional outcomes achieved by stroke survivors in an urban Western Cape Province 
setting to add to the information on stroke management.
Methods: A descriptive mixed methods study was done. Proportional, stratified random sampling was used to select 53 
participants from a population of 267. Quantitative data were collected with the Stroke Impact Scale Version 3.0 and the 
Modified Barthel Index, and analysed with the Mann-Whitney test. A p value of < 0.05 was deemed statistically significant. Five 
of the 53 participants were purposively sampled for the qualitative phase of the study. Qualitative data were analysed according to predetermined themes.
Results: Seventy-five per cent of participants were managed in a general medical ward. Four were admitted to a specialised 
inpatient rehabilitation centre. Eighty-three per cent received physiotherapy, 62% received occupational therapy and 57% 
received both physio and occupational therapy. Fifty-one per cent experienced communication difficulties, but only 18% received speech therapy.
Conclusion and recommendations: Sufficient inpatient therapy (preferably in a stroke unit /ward) and family education 
/training should be received before discharge. Occupational therapy, speech therapy, physiotherapy as well as psychological, 
social work, vision screening and dietetic services should be expanded at both hospital and community level.

Key words: Stroke, rehabilitation, occupational therapy