Physiotherapy
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Item Utilization of Physiotherapy in the continuum of stroke care at a tertiary hospital in Ibadan, Nigeria(Faculty of Medicine, Makerere University, 2017) Olaleye, O. A.; Lawal, Z. I.Objectives: To investigate the pattern of referral for and utilisation of physiotherapy in the continuum of stroke care at a tertiary hospital in Ibadan, Nigeria. Methods: Referral notes and medical records of patients admitted in the University College Hospital, Ibadan with a clinical diagnosis of stroke between January, 2009 and December, 2013 were retrospectively reviewed. Information on age, sex, type of stroke, length of hospital stay, referral for physiotherapy and utilisation of physiotherapy were retrieved. Data were summarised using descriptive statistics and analysed using Chi-square test. Results: A total of 783 patients with stroke were admitted in the hospital during the period under study. The in-patient mortal ity rate was 37.2%. The mean Length of Hospital Stay (LoHS) was 16.17±12.34 days. Referral rate for physiotherapy was high (75.8%) and the mean time from admission to referral for physiotherapy was three days. Majority of patients referred utilised physiotherapy (63.4%) and mean number of physiotherapy sessions received during in-patient care was 8.69±6.45. There was a significant association between LoHS and utilisation of in-patient physiotherapy (p=0.02). Conclusion: The referral rate of stroke patients for physiotherapy was relatively high. Utilisation of in-patient physiotherapy reduced length of hospital stay among patients with stroke. Utilisation of out-patient physiotherapy was low. Strategies to enhance out-patient utilisation should be explored.Item Comparison of Community Reintegration and Selected Stroke Specific Characteristics in Nigerian Male and Female Stroke Survivors(Department of Physiotherapy, College of Medicine University of Ibadan, Nigeria, 2014) Hamzat, T. K.; Ekechukwu, N. E.; Olaleye, O.A.This study investigated the difference between community reintegration of male and female stroke survivors and the association between gender of stroke survivors and some selected stroke specific characteristics (type, side of paresis and occurrence) Fifty-two patients (25 males and 27 females) recruited from hospitals in Nigeria took part in the study. Community reintegration (CR) was assessed three months post-admission discharge using the Reintegration to Normal Living Index (RNLI). Demographic and stroke-specific characteristics were obtained using a data form. Data were analysed using descriptive statistics, the Mann-Whitney U test and the chi-square test. Level of significance was set at p = 0.05. The mean age of the participants was 61.21 ± 11.25 years (range 31 – 86 years). There was no significant difference (p = 0.173) between the community reintegration scores of male and female participants. There was also no significant association between gender and each of the selected stroke specific characteristics such as type of stroke (p = 0.279); side of paresis (p = 0.250) and occurrence of stroke (p = 0.670). Community reintegration scores of male and female stroke survivors are not significantly different. There is no significant association between gender and each of the selected stroke specific characteristics.Item Informal Stroke Caregivers’ Satisfaction with Healthcare Services in a Tertiary Healthcare Centre in Ibadan, Nigeria(Athens Alexander Technological Educational Institute, 2014) Akinpelu, A. O.; Olaleye, O. A.; Odole, A. C.; Otaiku, O. A.Background: Many of the consequences of stroke affect not only the stroke survivor but also the informal caregiver. Most studies on informal stroke caregivers in literature are on the effects of care giving on the physical, emotional and psychological well-being of these carers. Considering the important role informal caregivers play in the rehabilitation process of the stroke survivor, there is the need to consider their views and expectations from care received by their care recipients. Objectives: This study investigated the satisfaction of informal stroke caregivers with healthcare services being received by their care recipients in a tertiary hospital in Ibadan. Methodology: Fifty consenting informal caregivers (12 males, 38 females) of stroke survivors receiving in-patient care on the medical wards of a tertiary healthcare facility participated in this cross-sectional survey. A self-developed, 3-part questionnaire adapted from the Caregivers’ Satisfaction with Stroke Care Questionnaire was used for this study. Results: The data collected was summarized using descriptive statistics of mean and percentages and illustrated with pie charts. Most of the participants (44%) were children of the patients. The results obtained showed that 48% of the participants were highly satisfied, 48% were satisfied while only 4% reported dissatisfaction. Areas of dissatisfaction were quality of food, water supply, electricity supply, waiting time and information about the condition of their care recipients. Conclusion: This study showed that the extent of satisfaction of informal stroke caregivers with inpatient care at the University College Hospital was good. It has also shown the need to routinely assess the satisfaction of informal carers with services being provided in the hospital for the purpose of quality assurance.Item Functional Ability, Community Reintegration and Participation Restriction among Community-Dwelling Female Stroke Survivors in Ibadan(Jimma University (Research and Publications Office), 2014) Hamzat, T. K.; Olaleye, O. A.; Akinwumi, O. B."BACKGROUND: Stroke is not gender-discriminatory. Yet, the subject of stroke among females has apparently not received significant attention from clinical researchers. The consequences of stroke include functional and psychosocial sequelae which may cause disability, hinder community reintegration and restrict participation. The inter-relationships among functional ability, community reintegration and participation restriction of community-dwelling, female stroke survivors in Ibadan were assessed in this descriptive study. METHODS: Fifty-two community-dwelling female stroke survivors (mean age = 56.55±9.91 years) were surveyed using consecutive sampling technique. Their functional ability level was measured using the Functional Independence Measure (FIM) while London Handicap Scale (LHS) was used to assess their participation restriction. Data were analyzed using Spearman Rank Correlation Coefficient (rho) and Mann-Whitney U test at p = 0.05. RESULTS: Significantly positive correlations (p< 0.05) were found between functional ability and community reintegration (r = 0.54; p = 0.01) as well as between participation restriction and community reintegration (r = 0.34; p = 0.05). Individuals with left hemiplegia had significantly higher mean rank scores in functional ability (30.41) than those who had right hemiplegia (mean rank scores = 21.94). CONCLUSION: Functional ability which appears to be related to stroke laterality showed positive association with both community reintegration and participation restriction. This suggests that improving the functional ability of the stroke survivors may reduce participation restriction and enhance their reintegration into the community. A similar study which compares male and female stroke survivors in the same community is thus necessary. "Item Development and Evaluation of a Primary HealthCare-based Physiotherapy Intervention and its Effects on Selected Indices of Stroke Recovery(MA Healthcare Ltd, 2013) Olaleye, O. A.; Hamzat, T. K.; Owolabi, M. O.Aim: To develop a Primary Healthcare-Based Physiotherapy Intervention (PHCPI) that requires simple, inexpensive, easy-to-use equipment for stroke rehabilitation and evaluate its effects on selected clinical indices of recovery among post-acute stroke survivors over a 10-week period. Methods: Three databases (Medline, Pubmed and PEDro) were used to identify treatment approaches with proven efficacy. The authors synthesised these treatment approaches to develop the PHCPI, which was used in a repeated measure design involving 25 (mean age=60.6 ± 10.2 years) consenting individuals with first-incidence stroke. These individuals were treated at a primary health centre, twice weekly for 10 consecutive weeks. Outcomes were assessed using the Modified Motor Assessment Scale (MMAS), the Short Form Postural Assessment Scale for Stroke (SF-PASS) and the Reintegration to Normal Living Index (RNLI), before the intervention and fortnightly thereafter. Walking speed and quality of life were also assessed before the intervention and at week 10 of it. Results: Within-subject multivariate analysis, after controlling for gender, showed a significant increase in motor function, postural balance, walking speed and quality of life. Their community reintegration scores also improved over the period. Conclusion: The PHCPI resulted in improved motor function, community reintegration, walking speed, postural balance and quality of life among community-dwelling stroke survivors. This intervention can be used for stroke rehabilitation at primary health centres.Item Standing asymmetry and functional ability in relation to gait parameters in hemiparetic stroke patients(Joint Centre for Research in Prosthetics & Orthotics and Rehabilitation Programmes, 2006) Hamzat, T. K.; Olaleye, O. A.; Adeniyi, A. F.; Awolola, E. O.Objective: Relationships between some temporospatial gait parameters and each of functional ability and standing asymmetry (measured as asymmetry ratio) in hemiparetic stroke patients were investigated. Design: Ex-post facto research design. Sample Size: Thirty-one (18 males and 13 females) patients with hemiparesis, aged between 35 and 65 years (56.97 ± 11.53) were consecutively recruited from the physiotherapy out-patient facility of a Nigerian teaching hospital. Measurements: Two weighing scales were used to measure relative standing weight distribution on each lower limb and subsequently converted to asymmetry ratio (AR), while functional ability was determined using the modified motor assessment scale. Gait parameters were assessed using foot print analysis, obtained during a 10-metre walk test. Pearson's correlation matrix (r) was calculated to establish relationship at 0.05 alpha. Results: Results showed a significantly negative correlation between asymmetry ratio and each of stride length, step length and functional ability (p<0.05). Significantly positive correlation was found between motor function and cach of stride length, step length, cadence, walking speed and step time (p<0.05) were obtained. Conclusion: The lesser the standing asymmetry in stroke patients, the better their motor functions and gait performance. Programmes aimed at enhancing weight bearing activities through the paretic lower limb, to attain standing symmetry, may be used to enhance functional ability and produce better gait functions in post-stroke patients.Item Stroke Rehabilitation: When Should Ambulation Activities Commence?(Medical Rehabilitation Therapists (Registration) Board of Nigeria, 2002) Olaleye, O. A.; Hamzat, T. K.Stroke is an important cause of disability worldwide. It results in considerable impairments such as sensory, motor, mental, perceptual and language functions. The motor deficits are characterized by hemiplegia and attendant physical limitation. Independent walking function is a highly desired goal among stroke survivors. It is therefore not surprising that recovery from the illness is often measured using ambulation as yardstick by both the patients and their relatives. This strong desire for ambulation often leads to pressure on the attending physiotherapist to commence ambulation promptly. However, some factors need to be taken into consideration by the physiotherapists before commencing ambulation in stroke rehabilitation. This article looks into issues that should be addressed before training ambulation in stroke patients undergoing rehabilitation.