ADHERENCE, FUNCTIONAL RECOVERY AND QUALITY OF LIFE IN STROKE PATIENTS

Adeniji OA1, Ogbonnaya LU2, Fatoye F31Federal Teaching Hospital Abakaliki, Physiotherapy Department, Abakaliki, Nigeria, 2Ebonyi State University, Department of Community Medicine, Abakaliki, Nigeria, 3Manchester Metropolitan University, Manchester, United KingdomBackground: It has been reported that poor adherence is usually high among patients with conditions that requires long term rehabilitation such as stroke. For this group of people, adherence is an important factor in Physiotherapy treatment outcome. Studies suggested that poor adherence to prescribed treatment might have significant effect on health outcome of patients, however, there are no sufficient studies that have assessed the effect of adherence on Physiotherapy treatment outcomes in Nigeria.Purpose: To investigate the effects of adherence to Physiotherapy on health outcomes for patients with strokeMethods: A Pre and Post-test study was conducted at the Federal Teaching Hospital, Abakaliki which is the only Teaching Hospital in Ebonyi State, Nigeria for a period of one year. There was consecutive recruitment of stroke patients referred for Physiotherapy within a year. Subject's attendance to the clinic appointments for this study was aligned to the routine practice in the department and each patient was followed up for six months. Patients baseline scores and post-intervention scores were recorded. Adherence comprised of three components which includes clinic attendance, Patient's adherence behavior's during clinic-based Physiotherapy session and home program adherence. Attendance register, sport injury rehabilitation adherence scale and patient self-report form were used to assess the three components respectively. The mean adherence score for all components was determined and 75% adherence was considered good adherence. In addition, motor function was assessed with Muscle assessment scale (MAS) whilst stroke specific quality of life questionnaire (SSQOL) was used in assessing quality of life. Data was analyzed using descriptive statistics, Paired t-tests was used to compare the data at baseline and post-intervention. Chi-Square was used examine the association between the level of adherence and both MAS and SSQL. Level of significance was set at p < 0.05. All analyses were carried out using SPSS version 22.Results: A total of 105 stroke patients (59% male and 41% female), with mean age 58 ±12.5 years participated in the study. Four percent of the participants adhere to treatment whilst 96% did not adhere. There was a significant relationship between level of adherence and quality of life (p < 0.001). However, there was no significant relationship between level of adherence and motor function recovery (p = 0.109). In addition, there was no significant change between baseline and post intervention scores for both MAS and SSQOL (p > 0.05).Conclusion(s): This study showed that adherence to Physiotherapy treatment by patient with stroke was poor. There was a significant relationship between adherence to Physiotherapy treatment and quality of life in stroke patients. However, there was no association between adherence and motor function recovery.Implications: Clinicians and policy makers are to be aware of the findings of this study and develop Physiotherapy interventions that can promote adherence to treatment as this may help to improve the health outcome of patients with stroke.Keywords: Stroke, Motor function recovery, Quality of lifeFunding acknowledgements: This study did not receive any fundingTopic: Neurology: strokeEthics approval required: YesInstitution: Ebonyi State UniversityEthics committee: University Research Ethics Committee (UREC)Ethics number: EBSU/DRIC/UREC/Vol. 04/0All authors, affiliations and abstracts have been published as submitted.