Measuring functional recovery in stroke patients: the responsiveness of ACTIVLIM-Stroke.

BACKGROUND AND PURPOSE: To determine the efficacy of the ACTIVLIM-Stroke questionnaire in detecting changes in functional status of stroke patients. METHOD: Sixty-eight Benin and Belgian stroke patients participated in this 2-month longitudinal study, involving baseline and follow-up assessments. Outcome measures combined ACTIVLIM-Stroke questionnaire, Barthel Index (BI), 6-minute-walk test (6MWT) and modified Rankin scale (MRS). Responsiveness of ACTIVLIM-Stroke was investigated through different methodological approaches and compared with BI, 6MWT and MRS. Statistical analyses were performed using the paired t tests, effect size (ES) and correlation tests. RESULTS: ACTIVLIM-Stroke detected changes in the whole sample (p<0.001, ES=0.78) and even in a subgroup of patients (p<0.001, ES=0.29) that were classified as stable according to the MRS. Moreover, ACTIVLIM-Stroke permitted the classification of patients into more discriminative groups, including those showing an important improvement (p<0.001, ES=1.87), a slight but non-clinically meaningful improvement (p<0.001, ES=0.38), and no improvement (p=0.1, ES=0.11), demonstrating its high sensitivity to change. Furthermore, there were concordant relationships between ACTIVLIM-Stroke change and any observed changes in BI, 6MWT and MRS scores (r≥0.50, p<0.001), confirming the external responsiveness of ACTVLIM-Stroke. CONCLUSIONS: ACTIVLIM-Stroke showed good responsiveness and can detect accurately clinical changes in the functional status of stroke patients. The BI and the 6MWT were also responsive and may provide complementary information while investigating change in functional status. However, in addition to being highly sensitive to change, ACTIVLIM-Stroke presents significant methodological advantages for quantifying functional changes in stroke patients

Box and block test in Beninese adults

OBJECTIVE: To determine the Box and Block Test norm in a sub-Saharan population and to compare these data with published norms for North American adults. METHODS: A total of 692 healthy Beninese people, age range 20–85 years, were recruited. These subjects were asked to perform the Box and Block Test with both hands. RESULTS: Box and Block Test scores (mean and standard deviation (SD)) for women and men were, respectively, 81.3 (15.4) and 79 (16.6) for the dominant hand and 73.2 (13.7) and 72 (14.8) for the non-dominant hand. Mean Box and Block Test scores ranged from 89.1 (12.7) for people under the age of 25 years to 55.23 (10.5) for people over the age of 74 years. Discussion: Manual dexterity was better for women than men, for dominant hand than non-dominant hand, and for younger subjects. In comparison with published results for US subjects, Beninese subjects had better dexterity below the age of 50 years in both sexes for the right hand and worse dexterity over 64 years of age in both sexes for the right hand. CONCLUSION: Developing and validating outcome scales in Africa will help to improve functional assessment of African populations in clinical practice and research

Feasibility of a self-rehabilitation program for the upper limb for stroke patients in Benin

Introduction: Stroke is major cause of disability and is responsible of a high cost especially in developing countries. The self-rehabilitation program constitutes a new and original treatment for stroke patients, likely to reduce the upper limb impairment and to improve activity and participation of the disabled people. The goal of this study is to evaluate the feasibility and effectiveness of a self-rehabilitation protocol in Benin..