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A. Banson1, O. Verner2, C. Yarfi1
1University of Health and Allied Sciences, Physiotherapy and Rehabilitation Sciences, Ho, Ghana, 2University of Health and Allied Sciences, Department of Microbiology, School of Medicine, Ho, Ghana
Background: Surviving stroke is only the beginning of lifelong management with respect to the effects of this condition. Among psychological and other challenges, 60% to 75% of stroke survivors are reported to be faced with cognitive and motor impairments; the interrelation thereof can impact function in these persons. Holistic post-stroke rehabilitation involves multiple health disciplines and should ideally address these residual deficits. However, despite its high prevalence, post-stroke cognitive impairments are often underreported and take the backseat at the expense of the more physical impairments and disabilities during medical rehabilitation.
Purpose: To review ten years of medical records of persons with stroke who undergoing physiotherapy in a Ghanaian municipal hospital with a focus on cognitive impairments. Researchers investigated the frequency of cognitive assessments, methods used, as well as specific referrals made on account of such impairments.
Methods: Demographic and clinical data of stroke cases which were managed in the physiotherapy department from January 2007 to December 2017 were collected. These records included both medical and physiotherapy documents. Where electronic information was absent, the paper folders were traced. Researchers looked out for any forms of cognitive assessments such as assessment tools or specific questions bothering on cognitive function. Researchers also examined records for specific referrals to other specialist professions on account of cognitive impairments. The outcome was presented in tables and figures.
Results: A total of 897 cases of stroke underwent physiotherapy within the review period, 892 of these were referred by physicians. There were 469 men and 428 women. Assessments were mainly focused on physical function for physiotherapy and medical for physician consults. Aside from pharmacotherapy, there were less than 5 referrals for any other rehabilitation service such as speech or nutritional support. There were also no indications of community care on discharge. In four cases, there was documentation of patients’ psychological state such as looking or feeling depressed. There were no specific assessments for cognitive function or any referrals made for cognitive assessment and management.
Conclusion(s): Findings strongly suggest that post-stroke cognitive impairment may be significantly underreported in this population because cognitive function was not assessed by physiotherapists or physicians as part of rehabilitation. Further studies ought to determine the knowledge level of these professions regarding post-cognitive function, its assessment and management.
Implications: Physiotherapists need to incorporate cognitive assessment and rehabilitation as part of stroke management and should refer to other members of the health team for further consultation and treatment when needed.
Funding, acknowledgements: Self funded
Keywords: post-stroke, cognitive function, assessment
Topic: Neurology: stroke
Did this work require ethics approval? Yes
Institution: University of Health and Allied Sciences
Committee: Research and Ethics Committee
Ethics number: UHAS-REC A.7 [1] 17-18
All authors, affiliations and abstracts have been published as submitted.
