Culturally-tailored task-specific exercise interventions for upper limb recovery in stroke survivors in sub-Saharan Africa: a scoping review

Upper limb impairment affects approximately 75% of stroke survivors at onset and persists in more than 50% beyond six months despite rehabilitation. Task-specific training (TST) is the most evidence-supported approach for post-stroke upper limb recovery. However, TST evidence has been generated almost entirely in high-income, Western clinical settings using tasks that reflect Western daily life. In sub-Saharan Africa and comparable low- and middle-income countries (LMICs), stroke survivors return to environments shaped by distinct cultural practices — such as pounding fufu, draping kente, beading, and sweeping — that are rarely represented in conventional rehabilitation protocols. Cultural relevance is a recognised determinant of patient engagement, motivation, adherence, and functional carry-over from clinic to daily life. Despite this, no scoping or systematic review has mapped the existing evidence on culturally-tailored task-specific upper limb rehabilitation in these contexts. This scoping review aims to map and characterise that evidence and identify gaps to guide future research and clinical practice in Ghana and comparable LMIC settings.