An Analysis of Stroke Quality of Life Profiles and the Role of Physiotherapy Adherence in Patients Managed at Victoria Chitepo Provincial Hospital in Mutare

Abstract

Stroke is the second-leading cause of death and the third-leading cause of death and disability combined in the world. The majority of the global stroke burden resides in lower-income countries like Zimbabwe. Physiotherapy plays a crucial role in stroke rehabilitation, helping patients regain strength, restore movement, and improve function and mobility. This study aimed to analyse the quality of life profiles and the role of physiotherapy adherence in stroke patients managed at Victoria Chitepo Provincial Hospital in Mutare. An analytical Cross-sectional study on patients with sequelae of stroke managed at VCPH for the period January 2023 to January 2024 was conducted. This study sought to determine if there is an association between adherence to physiotherapy and quality of life of stroke survivors. The study included all stroke patients who were 18 years or above, had a clinical or radiological diagnosis of stroke and had had physiotherapy services. Data was collected using a structured interviewer-administered questionnaire and a Stroke Specific Quality Of Life questionnaire (SSQOL). Data analysis was done using SPSS 20. The sample had 62 participants, 33(53.2%) males and 29(46.8%) females. The mean age of stroke onset was 40. History of smoking and the existence of a pre-existing condition were significant risk factors for a stroke in this study, with p<0.001 and p=0.002, respectively. Adherence to physiotherapy was attributed to financial constrains 30(48.4%), transport issues 12(19.4) and pain/depression 4(6.5%). From a possible score range of 49-245 for the 12 domains, the mean SSQOL score was 112, with high scores in vision 3.8/5 and language 3.3/5. The domains with the lowest scores were upper extremity function 1.3/5, social roles 1.8/5, and mobility 2/5. The average score across all domains was scores was 2.67, which signified poor quality of life profiles among the participants. Gender (T=0.001), marital status (T<0.001), history of smoking (T<0.001) and the number of physiotherapy sessions (T=0.024) were statistically significant factors that affected SSQOL scores in this study. Participants who had >20 sessions had higher SSQOL scores. The SSQOL scores were much lower compared to other studies. Stroke survivors suffer from more than just physical limitations. Failure of stroke survivors to perform social and family roles can lead to psychological problems. More effort should be made for the holistic management of stroke survivors across all affected domains. The author recommends setting up NCD registry and surveillance systems, strengthening stroke prevention strategies and using an integrated multidisciplinary approach for a holistic management of stroke survivors to improve their QOL in all aspects.