Current stroke rehabilitation services and physiotherapy research in South Africa.
Mokgobadibe V Ntsiea
PMID 31392288WHAT IT FOUND
South African stroke rehabilitation faces transport and service barriers.
Task-oriented circuit gait training and a multidisciplinary workplace intervention improved walking or return to work in trials, while caregiver education alone and pictorial home exercise prescriptions did not.
Key findings
01Task-oriented circuit gait training with caregiver help improved gait recovery and walking competency in a South African randomised trial of 144 stroke survivors.
02A multidisciplinary workplace intervention that included workability assessments and six workplace visits increased the odds of returning to work by 5.2 compared with usual care in a South African trial of 40 participants per group.
03Caregiver education alone did not improve patients' functional abilities, and adding written and pictorial instructions to a home exercise prescription did not improve adherence.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The review did not apply a formal quality rating to included studies. Unpublished South African theses and reports may have been missed if they were not available in public library repositories. Many intervention conclusions come from a small number of South African studies, and some studies were underpowered or limited to inpatient settings. Several positive interventions were delivered as bundled programmes, so the contribution of any single component cannot be separated. Some evidence was drawn from international studies judged relevant to South Africa, so it may not transfer to local services.
The easy way to misread this
Do not read this review as proof that every listed intervention works in South Africa. It does not grade study quality, and several positive findings come from single trials or bundled programmes, so the active component cannot always be separated.