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Start date: 2020Subject: search.filters.subject.Stroke

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    ‘We don’t have to do it together’: a qualitative study of Physiotherapists’ and patients’ perceptions about collaborative goal setting in Nigeria
    (Taylor & Francis, 2022) Olaleye, O. A.; Agoro, Z. B.
    Background: The adoption of Collaborative Goal Setting (CGS) is limited in most rehabilitation settings in Nigeria despite its recommendations in clinical practice guidelines. Objective: To explore the perceptions of physiotherapists and patients about CGS at a tertiary healthcare facility in Ibadan, Nigeria. Methods: We conducted focus group discussions among purposively selected physiotherapists (n = 8) and patients (4 stroke survivors, 3 patients with brain injury) to qualitatively explore their perceptions. Audio-taped discussions were transcribed verbatim and thematically analyzed. Results: We identified four themes around CGS which were: 1) paternalistic view of goal setting; 2) physiotherapists as goal setters; 3) perceived benefits of collaborative goal setting; and 4) barriers and facilitators to CGS. The physiotherapists articulated goals as expected outcomes from treat- ment and believed they were better poised and experienced to determine what patients could achieve during each phase of treatment. Patients' view of goal setting agreed with the physio- therapists', as they also opined that goal setting is the responsibility of physiotherapists. Time constraint, inadequate knowledge and the inability of patients to appropriately articulate their goals and expectations from treatment were barriers to CGS. Concerns about who to collaborate with when dealing with patients with impaired cognition and/or disorders of consciousness were raised by the physiotherapists. Participants in both groups indicated that education on how to set patient-oriented goals could facilitate CGS. Conclusions: Though rarely practiced, participants agreed that collaborative goal setting could be beneficial. Both the physiotherapists and patients require education on how to appropriately collaborate in setting goals of rehabilitation.
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    Relationship between post-stroke spasticity and functional ambulation among Nigerian stroke survivors
    (Nigeria Society of Physiotherapy, 2021) Olaleye, O. A.; Popoola, O. S.; Akosile, C. O.; Adegoke, B. O. A.
    Ambulation is a common goal of stroke rehabilitation that is often linked to lower limb spasticity. This study was conducted to investigate the relationship between paretic lower limb spasticity and functional ambulation after stroke. Thirty stroke survivors (19 males) aged 57.77 ± 9.52 years participated in this correlational cross-sectional study. Spasticity of the paretic lower limb was assessed using the Modified Tardieu Scale. Functional ambulation performance was assessed using the Emory Functional Ambulation Profile (E-FAP). Data were analyzed using Pearson's product moment correlation and stepwise regression analysis at p = 0.05. Spasticity was highest in the ankle plantaflexors (253.20 ± 32.62°). There was a significant relationship between spasticity of the affected lower limb and functional ambulation performance (r=0.61; p<0.05) Stepwise regression analysis indicated that only spasticity of the ankle plantaflexors predicted functional ambulation. Spasticity of the paretic ankle plantaflexors has discriminative power for predicting functional ambulation. This underscores the need for focused rehabilitation aimed at reducing spasticity of ankle plantaflexors for improved functional ambulation among stroke survivors.
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    Expectations of Individuals with Neurological Conditions from Rehabilitation: A Mixed-Method Study of Needs
    (South African Society of Physiotherapy, 2021) Olaleye, O. A.; Zaki, D. A.; Hamzat, T. K.
    Background: Knowledge of the specific expectations of patients with neurological conditions (NCs) from rehabilitation helps in setting attainable goals. Such expectations may vary from situation to situation. There are no studies investigating rehabilitation expectations amongst individuals with NCs in Nigeria. Objectives: The aim of our study was to explore the rehabilitation expectations of individuals with NCs. Method: This convergent mixed-methods study comprised a cross-sectional survey of 105 individuals with NCs and two sessions of Focus Group Discussions (FGDS) amongst eight individuals with NCs. The modified Needs Assessment Questionnaire was used to assess rehabilitation needs as a proxy for rehabilitation expectations, whilst disability was assessed using the World Health Organization Disability Assessment Schedule 2.0. Quantitative data were summarised using descriptive statistics and analysed using inferential statistics at p < 0.05. Thematic analysis was conducted on the qualitative data. Results: Sixty-one (58.1%) stroke survivors, 33 (31.4%) individuals with spinal cord injury (SCI) and 11 (10.5%) with traumatic brain injury (TBI) aged 46.48 ± 15.91 were surveyed. The need for social/recreational activity was the most expressed need (100%) amongst the participants. Mobility was reported as an important need constituting a barrier to enjoying life by 93 (88.6%) participants. Individuals with SCI expressed the greatest needs compared with the other two groups. Needs were significantly correlated with severity of disability (p < 0.05). Four overarching themes (physical health, financial, healthcare services/rehabilitation and emotional/social) representing major areas of needs emerged from the FGD data. Conclusion: Individuals with NCs in Nigeria have specified expectations of rehabilitation. Disability was a major driver of these expectations, irrespective of NC subtype. Clinical implications: Rehabilitation programmes for individuals with NCs should target expressed needs or expectations of each patient cohort and minimise disabilities associated with these conditions.
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    Early Mobilisation of Patients with Acute Stroke: A survey of knowledge, attitude and practice health care professionals in South-west, Nigeria
    (African Journals Online., 2020) Olaleye, O. A.; Amusan, O. I.; Adeyinka, A. O.
    BACKGROUND: Early mobilisation of acute stroke survivors has been associated with fewer deaths and better clinical outcomes. Yet, there are conflicting reports about the knowledge, attitude and practice of early mobilisation among clinicians. We investigated the knowledge, attitude and practice of early mobilization among health care professionals in South-West, Nigeria. MATERIALS AND METHODS: All the 159 health care professionals comprised 68(42.8%) nurses, 45(28.3%) physicians and 46(28.9%) physiotherapists involved in acute stroke care were surveyed using a content-validated questionnaire. Pearson’s Product Moment correlation and ANOVA were used to analyse data at p < 0.05. RESULTS: Most (n=147; 92.5%) of the participants agreed that early mobilization reduces complications of immobility. Majority of the HCPs were knowledgeable and had positive attitude towards early mobilisation (n=139; 87.4%). Attitude differed significantly across different healthcare professions (p=0.02). Most health care professionals (n=149; 93.7%) reported practicing early mobilization of acute stroke patients. There was a significant relationship between years of work experience and each of knowledge and attitude (p<0.05) CONCLUSIONS: Although, many health care professionals expressed concerns about the risks of early mobilization, including possibility of death, they reported practicing early mobilisation. It may be necessary to conduct a risk-benefit analysis of early mobilisation and provide appropriate practice guidelines to promote implementation. This could further enhance the health care professionals’ confidence in practicing early mobilisation and improve stroke care.
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    Perceived Barriers and Facilitators of Return to Driving Among a Sample of Nigerian Stroke Survivors – A Qualitative Study
    (Springer International Publishing, 2021) Nwankwo, K. O.; Olaleye, O. A.; Hamzat, T. K.; Ekechukwu, E. N. D.
    Stroke affects driving ability and as such impedes mobility, independence, freedom and quality of life. Return to driving after stroke serves as an integral part for community reintegration and improved quality of life. Driving is considered critical for continued independence, employment and recreation among stroke survivors. There was therefore the need to better understand the perceived facilitators and barriers to driving among stroke survivors with pre-stroke driving history. This study seeks to better understand the perceived facilitators of and barriers to return to driving after stroke so as to enable proper outcome in patient management and policy formulation. This is a qualitative phenomenological app roach using in-depth focus group discussion (FGD) was employed. Six stroke survivors (5 males; 1 female) aged 58.0 ± 7.9 years participated in the FGD. Half (50%) of the participants had returned to driving. Seven themes were generated for the barriers as well as facilitators of return to driving after stroke. Findings from this study suggests that majority of the facilitators of return to driving are intrinsic factors. Majority of stroke survivors wish that they could be able to stop being dependent on their caregivers for their activities of daily living (ADL) which could invariably lead to activity limitation and participation restriction. Attention should be paid on the pre-morbid driving status of stroke survivors so as to enhance the facilitators of return to driving and minimize the barriers to return to driving after stroke.