Impact of post-stroke impairments on activities and participation as experienced by stroke survivors in a Western Cape setting

Introduction: This paper explores causal connections between impairments, activity limitations and participation restrictions after stroke. Methods: The study population (N=267) of this descriptive study were public health care users, from the eastern sub-district of the Western Cape Metropole, who had a stroke between 1 January 2009 and 31 December 2010. Fifty-three study participants were selected through stratified, proportional, random sampling. Data was collected using the Stroke Impact Scale-3.0; the Modified Barthel Index; the Loewenstein Occupational Therapy Cognitive Assessment and a language screening test. Spearman correlations were used to determine statistical significance. Results: The mean Stroke Impact Scale participation score was 31.3/100. Limb strength (<0.01), visual perception (<0.01), spatial perception (0.02), motor praxis (<0.01), visuomotor organisation (<0.01), and thinking operations (<0.01), impacted participation scores negatively. The mean Modified Barthel Index score was 70.58/100. Limb strength (<0.01), hand function (<0.01), visual perception (<0.01), motor praxis (<0.01), visuomotor organisation (<0.01), and thinking operations (<0.01) impacted Modified Barthel Index scores negatively. Conclusion: Motor, cognitive and perceptual impairments impacted activities and participation negatively. Stroke survivors should receive routine cognitive, perceptual and motor evaluations. The effect of intervention strategies on cognitive and perceptual impairment post-stroke must be studied. Key words Stroke, cognition, perception, activities, participation