||Effectiveness of a self-rehabilitation program to improve upper-extremity function after stroke in developing countries: A randomized controlled trial..
NIAMA NATTA DIDIER ,
LEJEUNE THIERRY ,
DETREMBLEUR CHRISTINE ,
Yarou Bérénice ,
Sogbossi Emmanuel S. ,
ALAGNIDE HOUNTONDJI ETIENNE ,
KPADONOU GODONOU TOUSSAINT ,
Selves Clara ,
Stoquart Gaëtan ,
||Annals of Physical and Rehabilitation Medicine
||Background: About two-thirds of stroke patients present long-term upper-limb impairment and
limitations of activity, which constitutes a challenge in rehabilitation. This situation is particularly true
in developing countries, where there is a need for inexpensive rehabilitation solutions.
Objective: This study assessed the effectiveness of a self-rehabilitation program including uni- or bimanual
functional exercises for improving upper-limb function after stroke with respect to the context
in Benin, West Africa.
Methods: In this single-blind randomized controlled trial, chronic stroke individuals (>6 months post-
stroke) performed a supervised home-based self-rehabilitation program for 8 weeks (intervention
group); the control group did not receive any treatment. Participants were assessed before treatment
(T0), at the end of treatment (T1) and 8 weeks after the end of treatment (T2). The primary outcome was
the manual ability of the upper limb, assessed with ABILHAND-Stroke Benin. Secondary outcomes were
grip force, motor impairment (Fugl-Meyer Assessment – Upper Extremity), gross manual ability (Box
and Block test, Wolf Motor Function test) and quality of life (WHOQOL-26).
Results: We included 28 individuals in the intervention group and 31 in the control group. Adherence to
the program was 83%. After 8 weeks of self-rehabilitation, individuals in the intervention group showed
significantly improved manual ability and grip force as compared with the control group (P < 0.001),
with effect size 0.75 and 0.24, respectively. In the intervention group, the difference in average scores
was 10% between T0 and T1 and between T0 and T2. Subscores of physical and psychological quality of
life were also significantly improved in the intervention group. The other variables remained unchanged.
Conclusions: A self-rehabilitation program was effective in improving manual ability, grip force and
quality of life in individuals with stroke in Benin. More studies are needed to confirm these results in
International Classification of Functioning
Disability and Health
Quality of life