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To build a model of prediction of social participation of community-dwelling stroke survivors in Benin at 1 month, 3 months, and 6 months. An observational study with evaluations at 1 month, 3 months, and 6 months poststroke. Correlational analyses and multivariate linear regressions were performed. Outpatient rehabilitation centers in Benin. A volunteer sample of 91 stroke patients was enrolled at baseline; 64 (70%) patients completed all the study (N=64): 70% male and 52% right hemiparesis. Not applicable. Participants were evaluated with the Participation Measurement Scale, ACTIVLIM-Stroke (activities of daily living [ADL]), Stroke Impairment Assessment Set, 6-minute walk test, Hospital Anxiety and Depression Scale, and the modified Rankin Scale. The significant predictors of social participation after controlling the confounders were the following: at 1 month ADL (0.4 [0.3, 0.6]) and depression (‒0.6 [‒0.8, ‒0.2]) with total model R 2=0.44; at 3 months ADL (0.58 [0.4, 0.7]) and depression (‒0.58 [‒0.5, ‒0.7]) with total model R 2=0.65; and at 6 months ADL (0.31 [0.2, 0.5]), impairments (‒0.82 [‒0.5, ‒0.7]), and depression (‒0.94 [‒0.8, ‒0.2]) with total model R 2=0.78. Using socioculturally tailored tools, the present study identified ADL performance (ACTIVLIM-Stroke), depression (Hospital Anxiety Depression Scale), and overall impairments (Stroke Impairment Assessment Set) as the significant determinants of social participation (Participation Measurement Scale) poststroke in Benin. These findings will be a valuable resource for rehabilitation stakeholders in evaluating interventions, programs, and policies designed to encourage social participation for stroke patients. [ABSTRACT FROM AUTHOR]

• Physiotherapists working with sub(acute) stroke people focused on neuromuscular and musculoskeletal approaches. • Endurance exercises were rarely employed regardless of stroke severity. • Physiotherapists delivered less therapy time to mild stroke people. • For all disability levels, the therapy time did not progress over time. Physiotherapy is highly recommended for early recovery from stroke. This study aimed to document physiotherapy practices for people with acute and early sub-acute stroke in Benin. In this prospective observational study, physiotherapists working with acute stroke people documented the content of their treatment from six hospitals in Benin during the first session, at 2-week, and 1-month post-stroke with a standardized physiotherapy documentation form. We used the motricity index (MI) and trunk control test (TCT) to assess impairments, and the 10-meter walk test (10mWT), functional independence measure (FIM), walking, stair climbing, and dressing upper body subscales were used for activity limitations. Fifteen physiotherapists (60 % male, mean±SD age=31.3±5.8 years) recorded treatment sessions for 77 stroke participants (53.2 % male, mean±SD age=57.7±12.5 years). Physiotherapists focused on conventional physiotherapy approaches, including musculoskeletal (67 % of pre-functional activity time) and neuromuscular (53 % of sitting activity time) interventions. A significant difference was found between the therapy time delivered for people with mild, moderate, and severe stroke (p < 0.001). The MI (p= 0.033) and TCT (p= 0.002) measures showed significant improvement at 2-week and 1-month (p< 0.001) post-stroke, while 10mWT, FIM walking, stair climbing, and dressing upper body items significantly increased at 1-month (p< 0.001) but not at 2-week post-stroke. Physiotherapists working with acute stroke patients in Benin mainly use conventional neuromuscular and musculoskeletal interventions. In contrast, aerobic exercises were rarely employed regardless of stroke severity. Furthermore, our findings showed that the volume of physiotherapy sessions varied by stroke severity. [ABSTRACT FROM AUTHOR]

Abstract Objective To investigate responsiveness of the Participation Measurement Scale (PM-Scale) for the measurement of participation of stroke survivors. Design A 6-month observational study with 3 evaluation time points. Responsiveness of the PM-Scale was investigated over a period of 6 months. Setting Rehabilitation centers. Participants Stroke survivors (N =64); mean age ± SD, 56.9±12.6 years; sex, 45 men (70%). Interventions Not applicable. Main Outcome Measures Participants were evaluated using the PM-Scale. The modified Rankin Scale was used to categorize the overall disability level for each participant. Results The mixed-effect model analysis showed a significant difference in the participation over time (χ2=35.04; df =2; P <.001). In addition, the model exhibited significant effects of the sex, age, and disability at enrollment on the subjects' participation levels. Furthermore, the PM-Scale detected different levels of changes in the entire cohort over time (small change, effect size [ES]=0.33; moderate change, ES=0.67; and large change, ES=1). The PM-Scale also facilitated the classification of the participants into discriminative categories such as important improvement (t score≥1.96; 1.8≤ES≤2.13), moderate improvement (0< t score<1.96; 0.56≤ES≤0.78), no change (t score=0), moderate decrease (−1.96< t score<0; ES=0.67), and important decrease (t score≤−1.96; ES=1.47). Conclusions The PM-Scale exhibited good responsiveness and accurately detected changes in stroke subjects' involvement in life situations. These results validate the usefulness of the PM-Scale for clinical trials and in settings to evaluate the effects of interventions on subjects with stroke in Africa. [ABSTRACT FROM AUTHOR]

Objective To develop a valid stroke-specific tool, named the Participation Measurement Scale (PM-Scale), for the measurement of participation after stroke. Design Observational study and questionnaire development. Setting Outpatient rehabilitation centers. Participants Patients with stroke (N=276; mean age, 58.5±11.1y; 57% men). Interventions Not applicable. Main Outcome Measures Participants completed a 100-item experimental questionnaire of the PM-Scale. Items were scored as “not at all,” “weakly,” or “strongly.” The Hospital Anxiety and Depression Scale was used to evaluate depression, and the modified Rankin Scale was used to categorize the severity of disability on the basis of observation. Results After successive Rasch analyses using unrestricted partial credit parameterization, a valid, unidimensional, and linear 22-item scale for the measurement of participation was constructed. All 22 items fulfilled the measurement requirements of overall and individual item and person fits, category discrimination, invariance, and local response independence. The PM-Scale showed good internal consistency (person separation index, .93). The test-retest reliability of item difficulty hierarchy ( r =.96; P <.001) and patient location ( r =.99; P <.001) were excellent. This patient-based scale covers all 9 International Classification of Functioning, Disability and Health domains of participation. Conclusions The PM-Scale has good psychometric qualities and provides accurate measures of participation in patients with stroke in Africa. [ABSTRACT FROM AUTHOR]

to determine the frequency and factors associated with cognitive impairment after a stroke in Parakou. this was a descriptive and analytical cross-sectional study with an exhaustive census of all patients aged at least 50 years, who had a stroke and were followed in the neurology department of the CHUDB of Parakou from 2012 to 2018. The CSI-D, MMSE, Senegal test and DUBOIS 5 words test were used as collection tools for the assessment of cognitive functions. Analysis was performed using Epi info 7.1.3.3 software and IBM SPSS Statistics v21. Of 136 subjects over 50 years age, followed for stroke during the study period, 42 subjects were included. The mean age was 62.88±8.40 years with a sex ratio at 1.33 (57.14% male). The mean scores of the cognitive tests were 7.50 ±1.81 on the CSI-D; 25.18±4.06 on the MMSE and 31.11±6.08 on the Senegal test. The frequency of cognitive disorders was 28.57% in the CSI-D; 35.71% in the MMSE; 47.61% in the Senegal test and 19.04% in the DUBOIS 5-word test. The associated factors were the level of education (p=0.03), hypertension (p=0.04) and diabetes (p=0.01). The frequency of cognitive disorders is high among stroke victims in Parakou. [ABSTRACT FROM AUTHOR]

Background: The burden of stroke is high in Africa, but few data are available on the long-term outcome of strokes in this area.Aim: We aimed to study the long-term outcome of stroke survivors in Parakou from 2012 to 2018.Methods Of Study: It was a cohort study and included 247 stroke patients admitted to the University Hospital of Parakou from January 1, 2012 to April 30, 2018. Each patient was followed up for at least 1 year. The modified RANKIN scale was used to evaluate patients. Verbal autopsy was used to ascertain the cause of death. The survival probability was estimated using the Kaplan-Meier method. Predictors of mortality were estimated using the Cox proportional model and the hazard ratio (HR) and their 95% confidence intervals were determined. The data were analyzed using Stata Software.Results: The mean age was 58.1 ± 13.4 years with a sex ratio of 1.12. Among stroke survivors, the mortality was 10.1% at 3 months, 11.7% at 6 months, 15.4% at 1 year, 21.5% at 3 years, and 23.5% at 5 years. The probability of survival after a stroke was 66.5% at 5 years. Factors associated with mortality were age with adjusted HR 1.4 (1.2-1.7) for each 10 years, male sex with aHR 2.3 (1.2-4.6), history of hypertension with aHR 2.0 (1.0-4.1) and the severity of the initial neurological impairment National Institute of Health Stroke Scale with aHR 1.1 (1.0-1.2) for each 1 point. The main causes of death were recurrent stroke, infectious diseases, and cardiac disease. The proportion of patients with functional disability was 53.8% at 1 year. The quality of life was generally impaired in terms of physical health, personal environment, and finances.Conclusions: The long-term prognosis of stroke patients in Parakou is poor. It requires urgent action to reduce this burden. [ABSTRACT FROM AUTHOR]

The prevalence of physical inactivity after stroke is high and exercise training improves many outcomes. However, access to community training protocols is limited, especially in low-income settings. To investigate the feasibility and efficacy of a new intervention: Circuit walking, balance, cycling and strength training (CBCS) on activity of daily living (ADL) limitations, motor performance, and social participation restrictions in people after stroke. Forty-six community-dwelling individuals with chronic stroke who were no longer in conventional rehabilitation were randomized into an immediate CBCS group (IG; initially received CBCS training for 12 weeks in phase 1), and a delayed CBCS group (DG) that first participated in sociocultural activities for 12 weeks. In phase 2, participants crossed over so that the DG underwent CBCS and the IG performed sociocultural activities. The primary outcome was ADL limitations measured with the ACTIVLIM-Stroke scale. Secondary outcomes included motor performance (balance: Berg Balance Scale [BBS], global impairment: Stroke Impairment Assessment Set [SIAS] and mobility: 6-minute and 10-metre walk tests [6MWT and 10mWT] and psychosocial health [depression and participation]). Additional outcomes included feasibility (retention, adherence) and safety. ADL capacity significantly improved pre to post CBCS training (ACTIVLIM-stroke, +3,4 logits , p < 0.001; effect size [ES] 0.87), balance (BBS, +21 points , p < 0.001; ES 0.9), impairments (SIAS, +11 points, p < 0.001; ES 0.9), and mobility (+145 m for 6MWT and +0.37 m/s for 10mWT; p < 0.001; ES 0.7 and 0.5 respectively). Similar improvements in psychosocial health occurred in both groups. Adherence and retention rates were 95% and 100%, respectively. CBCS was feasible, safe and improved functional independence and motor abilities in individuals in the chronic stage of stroke. Participation in CBCS improved depression and social participation similarly to participation in sociocultural activities. The benefits persisted for at least 3 months after intervention completion. PACTR202001714888482 [ABSTRACT FROM AUTHOR]

• The Brazilian version of the PM-Scale is both valid and reliable. • The Brazilian version of the PM-Scale is a unidimensional assessment instrument based on the ICF and calibrated using the Rasch model. • This is a low-cost scale that can be administered in less than five minutes, which facilitates assessment in clinical practice. • The PM-Scale can contribute to clinical practice and long-term care for the Brazilian population of stroke survivors and provides useful information for the scientific community. The PM-Scale was developed specifically to assess participation in individuals after stroke based on the concepts contained in the International Classification of Functioning, Disability and Health. However, this measure is only available in English and French. To translate and cross-culturally adapt the PM-Scale to Brazilian Portuguese, followed by the validation and testing of reliability of the translated version. The translation process followed standard guidelines. Preliminary test-retest reliability was determined using the intraclass correlation coefficient (ICC 2,1). The Rasch model was employed to analyse the validity, unidimensionality, invariance, and internal consistency of the Brazilian version of the PM-Scale. The final translated version of the PM-Scale presented appropriate semantic, idiomatic, cultural, and conceptual equivalence. The preliminary analysis revealed excellent intra-observer and inter-observer reliability (ICC 2, 1 = 0.91; 95%CI: 0.83, 0.95 and ICC 2, 1 = 0.81; 95%CI: 0.64, 0.89, respectively). The analysis of the Rasch model revealed only one erratic item. An excellent overall fit was found for items (mean ± SD = 0.01 ± 1.02) and adequate fit was found for persons (mean ± SD = 1.16 ± 0.88). Internal consistency was considered adequate (person separation index = 1.77, reliability = 0.76). No significant invariance was found with regards to the personal characteristics of the sample (p > 0.05). The Brazilian version of the PM-Scale is a valid, unidimensional, linear, reliable scale for measuring participation in stroke survivors and can be administered in less than five minutes. [ABSTRACT FROM AUTHOR]