Upper limb rehabilitation in (sub)acute stroke in West African low-income countries: An observational prospective study focusing on dose and content

Abstract

Upper limb rehabilitaon in (sub)acute stroke in West African low-income countries: An observaonal prospecve study focusing on dose and content Introducon: The content and dose of upper limb training, the main components of rehabilitaon aer a stroke, is not known in low-resource income countries. Objecve: To idenfy the content and dose of upper limb rehabilitaon in early phase poststroke in Burkina Faso and Benin. Methods and paents: An observaonal prospecve study was conducted in hospital and rehabilitaon centre sengs in Burkina Faso and Benin. Sessions of paents in the acute and subacute phase of stroke were observed for 4 weeks by recording the content and dose of upper limb rehabilitaon using a standardized taxonomy of acvies form. Results: Eighty-one paents (Burkina Faso n=59 and Benin n=22) and 35 physiotherapists were observed. The median number of sessions during 4 weeks was 8 with 30 minutes median session length and a median duraon of upper limb training of 15 minutes per session. The dose of therapy is higher in Benin than in Burkina Faso (P< 0.001). The upper limb training consisted of performing pre-funconal acvies for 85% of the me. Conclusion: Upper limb physiotherapy in the early phase poststroke in low income countries was focused only on pre-funconal acvies and provided at a low dose. Future research should invesgate how higher dose involving funconal training could be provided in countries such as Burkina Faso and Benin taking into account the importance of improving upper limb in daily acvies with the limited resources available.