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 physioand
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