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INTRODUCTION: La coronaropathie serait fréquente chez les survivants d´accident vasculaire cérébral (AVC). L´objectif de l´étude était de déterminer la prévalence de la coronaropathie chez les survivants d´AVC suivis au centre hospitalier universitaire départemental Borgou-Alibori (CHUD/B-A). METHODES: il s´est agi d´une étude transversale menée du 1er mars au 31 août 2019. Elle a inclus tous les patients victimes d´AVC, d´âge = 18 ans, reçus dans l´unité de neurologie du CHUD/B-A entre janvier 2012 et juillet 2019, ayant survécu à la phase aiguë, et chez qui le consentement éclairé écrit ou celui d´un tuteur (patients sévèrement handicapés) a été obtenu. Un entretien individuel, des mesures anthropométriques, un examen physique, un électrocardiogramme et une revue du dossier médical ont été effectués. La présence de coronaropathie a été définie par un antécédent documenté, des anomalies ST/T et/ou Q évocatrices (critères de Minnesota) ou un questionnaire de dépistage de l´angine de poitrine positif. Les facteurs associés à la coronaropathie ont été recherchés par une régression logistique. RESULTATS: un total de 101 patients était inclus avec un âge moyen de 57,2±10,5 ans. Le délai médian depuis la survenue de l´AVC était de 11 mois [2,0-23,5]. Les AVC ischémiques prédominaient (57,4%). La prévalence de la coronaropathie était estimée à 49,5%. Les facteurs associés à la coronaropathie étaient la non-scolarisation (p=0,036), l´obésité (p=0,036) et le tabagisme ancien (p=0,044). CONCLUSION: cette étude montre une fréquence élevée de coronaropathie chez les survivants d´AVC. Il est important de dépister la coronaropathie dans cette cible afin d´optimiser la prise en charge.

High-intensity interval training (HIIT) has been shown to benefit stroke patients when implemented three months post-stroke. This study examined HIIT's feasibility and clinical effectiveness in the early post-stroke stage in Benin. This was a prospective interventional study comprising an HIIT programme executed on a recumbent bike, three times/week, 20–30 min/session for 6 weeks, added to a conventional physiotherapy. The primary outcomes were feasibility, credibility and expectancy assessed with credibility and expectancy questionnaire. A maximal exercise test, 6-min walking test (6MWT), 10-m walking test (10mWT), Berg balance scale (BBS) and five repetitions sit-to-stand test (5 R-STS) were performed before and after the training programme. Ten outpatients, with a median age [P25-P75]: 63.5[56.7–71.2] years; time since stroke: 15.0[9.7–21.0] days, started and completed all training sessions without serious adverse events. High scores were observed on the Credibility subscale at admission (27.0[25.7–27.0]), which remained so after intervention (26.5[25.7–27.0]). Expectancy subscale scores were high at admission (25.5[24.0–27.0]) and post-training (25.5[24.5–27.0]). Peak workload (p < 0.001), BBS (p < 0.001), 6MWT (p < 0.001), 10mWT (p < 0.001) and 5 R-STS (p = 0.004) were all improved. HIIT is feasible and safe in the early subacute post-stroke stage and is perceived by patients as highly credible, meeting their expectations of recovery. [ABSTRACT FROM AUTHOR]

Objective: Modern clinical rehabilitation practice aligned to the International Classification of Functioning, Disability and Health and the Convention on the Rights of Persons with Disabilities highlights the importance of attention to participation in the rehabilitation formulation. This systematic review investigates the efficacy of rehabilitation interventions evaluated in common neurological disorders reported to influence participation outcomes. Data sources: PubMed, Web of Science and PsycINFO databases were searched from inception to 25 April 2023. Only randomised controlled trials were considered for inclusion. Review methods: The data were extracted by two independent reviewers in the following categories: characteristics of the included study publications, description of intervention and outcome measures. Results: A total of 1248 unique article records were identified through the databases. Twenty-eight randomized controlled trials were included with 15 publications having participation as a primary outcome measure. Articles were related to multiple sclerosis (N = 4), spinal cord injury (N = 2), stroke (N = 16) and traumatic brain injury (N = 6). Four publications showed significant differences in pre- and post-intervention within experimental groups. All four articles described participation as primary outcome measure. Conclusion: There is a limited evidence of the identified rehabilitation interventions to improve participation in common neurological conditions. However, there was a paucity of articles involving individual with Parkinson's disease that met the inclusion criteria. [ABSTRACT FROM AUTHOR]

Currently, little is known on the relationships between cardiorespiratory fitness (CF), physical activity (PA), and functional outcomes after stroke, especially in low- and middle-income countries. We examine the relationships between CF, PA, and functional outcomes in one-year poststroke in Benin, a lower middle-income country. A case–control study was carried out in northern Benin. Twenty-one participants with chronic strokes were matched to 42 controls according to sex and age. PA patterns and associated energy expenditure (EE) were assessed with a BodyMedia's senseWear armband. CF was evaluated with the Physical Working Capacity at 75% of the predicted maximal heart rate index. The functional outcomes were evaluated using the modified Rankin scale (mRS) and the ACTIVLIM-Stroke scale. Both people with stroke and the healthy pairs spent much time in sedentary behavior (median [P25; P75]: 672 [460; 793] min vs 515 [287; 666] min, p = 0.006). Although people with chronic stroke performed fewer steps compared to healthy controls (median: 2767 vs 5524, p = 0.005), results showed that total EE was not statistically significant in either group (median: 7166 Kcal vs 8245 Kcal, p = 0.07). In addition, the mRS score (r = 0.47, p = 0.033) and the ACTIVLIM-Stroke measure (r = 0.52, p = 0.016) were moderately associated with the CF index of people with chronic stroke. The study showed clear trends for lower levels of PA in both people with chronic stroke and health controls. A correlation exists between CF, disability, and functional outcomes among stroke patients. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this systematic review was primarily to identify the types of mHealth technologies for the rehabilitation of non-specific spinal disorders, second to evaluate their efficacy, and finally to determine their applicability in LMICs. Methods: Three databases (Scopus, PubMed, and Web of Science) were searched for randomized controlled trials and clinical trials from January 2012 until December 2022. Studies were found eligible when using mHealth technologies for the rehabilitation of non-specific spinal disorders. To evaluate efficacy, the primary outcome was pain intensity, and the secondary outcomes were disability and quality of life. To evaluate the applicability in LMICs, information about financial and geographical accessibility, offline usability, and languages was extracted. Results: Fifteen studies were included comprising 1828 participants who suffer from non-specific low back pain (86.05%) and non-specific neck pain (13.95%). Fourteen distinct smartphone-based interventions and two sensor system interventions were found, with a duration ranging from four weeks to six months. All mHealth interventions demonstrated efficacy for the improvement of pain, disability and quality of life in non-specific spinal disorders, particularly low back pain. Five of the evaluated smartphone applications were free of charge accessible and had language features that could be adapted for use in LMICs. Conclusion: mHealth interventions can be used and integrated into the conventional treatment of non-specific spinal disorders in rehabilitation. They have demonstrated efficacy and could be implemented in LMICs with minor adaptations to overcome language barriers and the absolute necessity of the internet. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the knowledge and use of effective communication strategies among Italian physiotherapists. We utilized a questionnaire consisting of 19 questions to collect data on the knowledge and use of effective communication strategies among Italian physiotherapists. The results revealed that only 35.8% of the respondents reported being aware of communication strategies related to physiotherapy, with their first exposure occurring during their three-year degree. Despite the majority of respondents agreeing that communication is an effective strategy for improving patient adherence, only about half reported making moderate use of open-ended questions and metaphors during treatment sessions. Furthermore, more than half of the respondents reported being unaware of Motivational Interviewing. The results of this study found that there is a consensus among Italian physiotherapists about the importance of effective communication in clinical practice, though the knowledge and application of some communication strategies remain limited. These findings suggest that there is room for improvement in the training and education of physiotherapists in Italy, with a need for greater emphasis on communication strategies in the university educational curriculum, starting from the bachelor's degree. [ABSTRACT FROM AUTHOR]

To review and quantify the effects of walking training for the improvement of various aspects of physical function of people with chronic stroke. We conducted a systematic search and meta-analysis of randomized controlled trials (RCTs) of chronic stroke rehabilitation interventions published from 2008 to 2020 in English or French. Of the 6476-screened articles collated from four databases, 15 RCTs were included and analyzed. We performed a meta-regression with the total training time as dependent variable in order to have a better understanding of how did the training dosage affect the effect sizes. Treadmill walking training was more effective on balance and motor functions (standardized mean difference (SMD)=0.70[0.02, 1.37], p = 0.04) and 0.56[0.15, 0.96], p = 0.007 respectively). Overground walking training improved significantly walking endurance (SMD = 0.38[0.16, 0.59], p < 0.001), walking speed (MD = 0.12[0.05, 0.18], p < 0.001), participation (SMD = 0.35[0.02, 0.68], p = 0.04) and quality of life (SMD = 0.46[0.12, 0.80], p = 0.008). Aquatic training improved balance (SMD = 2.41[1.20, 3.62], p < 0.001). The Meta-regression analysis did not show significant effect of total training time on the effect sizes. Treadmill and overground walking protocols consisting of ≥30 min sessions conducted at least 3 days per week for about 8 weeks are beneficial for improving motor impairments, activity limitations, participation, and quality of life in people with chronic stroke. Treadmill walking training is effective for improving balance and motor functions. Overground walking training improved significantly walking endurance, walking speed, participation and quality of life. Treadmill and overground walking protocols consisting of ≥30 min sessions conducted at least 3 days per week for about 8 weeks are beneficial for improving motor impairments, activity limitations, participation, and quality of life in patient with chronic stroke. [ABSTRACT FROM AUTHOR]

Purpose: The study aimed to review the content and evaluate the effects of CBR on quality of life (QoL), balance, and walking capacity for people post stroke, compared to other rehabilitation protocols or no care. Methods: A systematic search and meta-analysis of clinical trials of CBR interventions for stroke survivors was conducted. Five online electronic databases (MEDLINE/PubMed, Web of sciences, Scopus, Hinari, and Pedro) were searched for articles published in English and French languages, from inception up to December 2021. Sixteen studies were included that reported on QoL outcomes from CBR interventions involving 1755 adults post stroke. Results: The different CBR interventions that were selected were grouped into three clusters: a) exercise programmes, b) task-oriented training, and c) educational and taking-charge programmes. CBR interventions were more effective than other rehabilitation protocols (SMD=0.16[0.02, 0.30], P=0.03, I² =40%) on QoL for people with chronic stroke. The effects of interventions on walking capacity and balance demonstrated non-significant difference (SMD=0.31[-0.02, 0.64], P=0.06, I² =88%, and SMD= 0.20[-0.12, 0.53], P=0.22, I² =68%, respectively). Conclusion: Current data indicates that CBR can be used in many forms or in combinations to benefit people with chronic stroke. Also, CBR is as effective as other rehabilitative protocols or no care on walking capacity and balance, while being more while being more effective than institution-based rehabilitation or no care effective than institution-based rehabilitation or no care, in improving quality of life which is a well-recognised goal in the rehabilitation of people with chronic stroke. [ABSTRACT FROM AUTHOR]

Background: The burden of stroke is high in sub-Saharan Africa; however, few data are available on long-term mortality. Objective: To estimate over one-month stroke case fatality in sub-Saharan Africa. Methods: A systematic review and meta-analysis were performed according to meta-analysis of observational studies in epidemiology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO protocol: CRD42020192439), on five electronic databases (PubMed, Science direct, AJOL, EMBASE, and Web of Sciences). We searched all studies on stroke case fatality over one month in sub-Saharan Africa published between 1st January 2000 and 31st December 2019. Results:We included 91 studies with a total of 34,362 stroke cases. The one-month pooled stroke case-fatality rate was 24.1% [95% CI: 21.5-27.0] and 33.2% [95% CI: 23.6-44.5] at one year. At three and five years, the case-fatality rates were respectively 40.1% [95% CI: 20.8-63.0] and 39.4% [95% CI: 14.3-71.5] with high heterogeneity. Hemorrhagic stroke was associated with a higher risk of mortality at one month, but ischemic stroke increased the risk of mortality over six months. Diabetes was associated with poor prognosis at 6 and 12 months with odds ratios of 1.64 [95% CI: 1.22-2.20] and 1.85 [1.25-2.75], respectively. Conclusion: The stroke case fatality over one month was very high, compared to case fatalities reported in Western countries and can be explained by a weak healthcare systems and vascular risk factors. [ABSTRACT FROM AUTHOR]

WHO defines physical activity (PA) as any bodily movement produced by skeletal muscles that requires energy expenditure (EE). The purpose of this study was to compare the EE estimations by ActiGraph GT3X+ with a gold standard measurement, the portable gas analyser in a set of 3 different PAs. This cross-sectional study involved 56 participants, age range (years, [min, max]: young people [20, 33], older adults [65, 83]). Participants completed a single session of three experimental PAs including biking, treadmill walking, and treadmill running. Each participant wore five GT3X+ triaxial accelerometers and a portable gas analyser used as the gold standard measurement. The GT3X+ were placed on the wrists, the waist (centred at the pelvis), and the ankles. ActiGraph GT3X+ and MetaMax3B records were investigated through intraclass correlation coefficient. Magnitude of measurement error was estimated using Effect Size. The GT3X+ wrist and GT3X+ waist underestimated EE regardless of the PA type. The GT3X+ ankles strongly overestimated EE during biking (mean bias = 489 ± 392%) and walking (mean bias = 106 ± 58%), while it underestimated EE during running (mean bias = −47 ± 27%). The ActiGraph GT3X+ does not provide accurate EE estimates across a range of placement locations during moderate and high-intensity PA. [ABSTRACT FROM AUTHOR]

Introduction: We aimed to determine knowledge of stroke risk factors and signs in an urban population of northern Benin. Methods: A door-to-door purposeful sampling survey was conducted in resident population (age ≥15 years) of the district of Titirou in the city of Parakou (N = 255,478) in Benin between March 15 and July 15, 2016. In-person interviews were conducted with data collection on structured questionnaires with close and open questions, according to standard definitions. Multivariable logistic regression was used to assess predictors of good knowledge, defined by provision of a correct response in pre-defined set of questions on stroke risk factors and warning signs. Results: Of 4,671 participants (mean age 27.7 ± 12.9 years; females 50.6%), only 404 (8.6%) knew at least 1 stroke risk factor. Knowledge level of stroke risk factors (odds ratio, 95% confidence interval) was related to age (1.37, 1.27–1.48), level of education (2.54, 1.73–3.72), and family history of stroke (3.01, 2.08–4.26). Only 230 (4.9%) were able to cite at least 1 stroke symptom, and this knowledge was great with increasing age (1.04, 1.02–1.06), family (3.63, 2.41–5.49) and personal history of stroke (3.71, 1.86–7.42), and high level of education (4.35, 2.68–7.07). Conclusion: Knowledge of stroke risk factors and signs is low in northern Benin. Greater public education and awareness campaigns are required to address the burden of stroke. [ABSTRACT FROM AUTHOR]

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]

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]

Introduction: coronary artery disease seem common in stroke patients. We aimed to determine the prevalence of coronary artery disease in stroke survivors followed at the Borgou-Alibori Departmental University Hospital (CHUD/B-A). Methods: this was a cross-sectional study, conducted from March 1 to August 31, 2019. It included all stroke patients, aged ≥ 18 years, received in the neurology unit of CHUD-B/A between January 2012 and July 2019, having survived the acute phase, and from whom written informed consent or that of a guardian (severely disabled patients) has been obtained. An individual interview, anthropometric measurements, a physical examination, an electrocardiogram record and a review of the medical record were performed. The coronary artery disease was defined by a documented history, suggestive ST/T and/or Q abnormalities (Minnesota criteria) or a positive angina screening questionnaire. The factors associated with coronary artery disease were investigated by logistic regression. Results: a total of 101 patients were included with an average age of 57.2 ± 10.5 years. The median time since stroke onset was 11 months (interquartile range: [2.0- 23.5]). Ischemic stroke predominated (57.4%). The prevalence of coronary artery disease was estimated at 49.5%. The factors associated were lack of school education (p=0.036), obesity (0.036) and former tobacco use (p=0.044). Conclusion: this study shows a high frequency of coronary artery disease in stroke patients. It is important to detect coronary artery disease in this target population in order to improve the management. [ABSTRACT FROM AUTHOR]