Relationship between Post-Stroke Cognitive Impairment and Functional Activity of Stroke Survivors in Maiduguri, Borno State Nigeria

Abstract

Stroke survivors often experience serious cognitive impairment which may impact on their functional activity and the ability to lead an independent life. However, there is paucity of information on the relationship between post-stroke cognitive impairment (PSCI) and functional activity of Nigerian stroke survivors. This study therefore examined the relationship between post-stroke cognitive impairment (PSCI) and functional activity of stroke survivors attending physiotherapy clinics in Maiduguri, north-eastern Nigeria. A cross sectional study design was utilized and a purposive sampling technique was used to recruit participants for this study. One hundred stroke patients from Physiotherapy clinics in Maiduguri, north-eastern Nigeria participated in this study. Data forms were used to obtain information on socio-demographic and clinical characteristics of the participants while Mini-Mental State Examination (MMSE) and Barthel Index (BI) scale were used to obtain information on cognitive impairment and functional activity of the participants respectively. Descriptive statistics of mean, standard deviation, frequency and percentages were used to summarise the socio-demographic and clinical characteristics of the participants. Spearman’s Rank Order Correlation was used to investigate the relationship between PSCI and overall functional activity of the participants on one hand and between PSCI and components of functional activity of the participants. Out of the 100 stroke survivors that participated in the study, 55% were male while 45% were female. The mean age and post-stroke duration of the participants were 55.16 ± 10.01 years and 9.90 ± 10.07 months respectively. The results showed that a positive and significant relationship existed between PSCI and overall functional activity of the participants (r = 0.55, p = 0.00). Similarly, there was a significant and positive correlation between PSCI and the components of functional activity except with the bowel control component of functional activity. The correlations were varied with the highest correlation observed between PSCI and mobility component (r = 0.58, p = 0.001) while the lowest correlation was between PSCI and the bowel control component (r = 0.17, p = 0.10). the correlation coefficient for the other components namely the feeding, bathing, grooming, dressing, bladder control, toilet use, transfer and stair climbing were 0.40, 0.45, 0.40, 0.41, 0.39, 0.44, 0.50 and 0.53 respectively. The outcome of this study showed that the relationship between PSCI and functional activity of the stroke survivors was significant and positive. Furthermore, correlation was highest between PSCI and mobility component of functional activity. It is concluded that reducing PSCI could positively impact on the functional activity of stroke survivors, and enhancing functional activity could also reduce Post-Stroke Cognitive Impairment (PSCI) and therefore Physiotherapists should endeavor to assess cognitive impairment among stroke patients and incorporate treatment strategies that will enhance functional outcome.