Stroke Severity Variations in a 12 Month Prospective Study Involving Sub-acute Ischemic Stroke Survivors With and Without Cognitive Impairment in Nnewi, Nigeria
U. P. Okonkwo *
Department of Physiotherapy, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
S. C. Ibeneme
Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, University of Nigeria, Enugu Campus, Enugu State, Nigeria
C. Ihegihu
Department of Surgery, Faculty of Medicine, Nnamdi Azikiwe University, Awka, Nigeria
I. C. Ezema
Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, University of Nigeria, Enugu Campus, Enugu State, Nigeria
E. C. Okoye
Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, Nnamdi Azikiwe University, Awka, Anambra State, Nigeria
V. A. Egwuonwu
Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, Nnamdi Azikiwe University, Awka, Anambra State, Nigeria
E. N. Ekechukwu
Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, University of Nigeria, Enugu Campus, Enugu State, Nigeria
O. Azubike
Department of Physiotherapy, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
*Author to whom correspondence should be addressed.
Abstract
Background: Stroke severity may intensify with cognitive impairments (CI), and impede functional recovery. Therefore proprioceptive neuromuscular facilitation (PNF) and task specific balance training (TSBT) was an exercise intervention package for stroke survivors with and without cognitive impairment (CI).
Objective: To determine stroke severity variations in sub-acute ischemic stroke survivors with CI and without CI after 12 months prospective study
Methods: One hundred of 143 available sub-acute first-ever ischemic stroke survivors recruited using convenience sampling technique in a non-randomized controlled clinical trial. They were later conveniently allocated to a cognitive impaired group (CIG) and non-cognitive impaired group (NCIG). Proprioceptive neuromuscular facilitation (PNF) and task-specific neuromuscular facilitation (TSBT) interventions applied 3 times a week, 60 mins per session, for 12 months to the two groups. Data analysis was by independent t-test, and repeated measure ANOVA. The outcome measure was National Institute of Stroke Scale (NIHSS). The significance level was at p<0.05.
Results: There was statistical significant (p<0.05) improvement across time points in the stroke severity of CIG and NCIG with a large effect size of .773 and 0.641 after 12 months of PNF and TSBT. There was statistical significant difference between the two groups
Conclusions: Within the groups, a 12-month PNF and TSBT intervention improved stroke severity recovery in the two groups. However, there was significant variation in improvement between the two groups at 4 months of treatment and other time points probably because of effect of cognitive impairment, age differences and the significant difference between NIHSS scores at baseline.
Keywords: Stroke, cognitive impairment, stroke severity, task specific balance training, pro-prioceptive neuromuscular facilitation