Cognitive Recovery Outcome in a 12 Month Quasi-experimental Study Involving Sub-acute Stroke Survivors in Selected Hospitals in Nnewi, Anambra State, Nigeria
U. P. Okonkwo *
Department of Physiotherapy, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
G. C. Okoye
Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, University of Nigeria, Enugu Campus, Nigeria
A. O. Ezeukwu
Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, University of Nigeria, Enugu Campus, Nigeria
M. J. Nwankwo
Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, Nnamdi Azikiwe University, Awka, Nigeria
V. A. Egwuonwu
Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, Nnamdi Azikiwe University, Awka, Nigeria
O. P. Ibikunle
Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, Nnamdi Azikiwe University, Awka, Nigeria
C. O. Azubike
Department of Physiotherapy, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
E. E. Okoye
Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, Nnamdi Azikiwe University, Awka, Nigeria
*Author to whom correspondence should be addressed.
Abstract
Background: Studies estimate that up to 85 percent of people who suffer a stroke will have cognitive impairments, including deficits in executive function, attention and working memory. New evidence indicates that exercise exerts its effects on cognition by affecting molecular events related to the management of energy metabolism and synaptic plasticity. Therefore, combining Proprioceptive Neuromuscular Facilitation (PNF) and Task-specific Balance Training (TSBT) to facilitate global cognitive recovery and maintenance on cognitive impaired and non-cognitive impaired sub-acute ischemic stroke subtype with first ever cerebral ischemia was the focus of study.
Methods: The study was a 12-month quasi experimental study of cognitive recovery outcome following PNF and TSBT intervention involving 143 stroke survivors in selected hospitals in Nnewi, Nigeria. The ischemic stroke subtypes with first ever cerebral ischemia were recruited using convenience sampling technique after a neuropsychiatric test done under the supervision of a neurologist. About 100 participants that completed the study were allotted into a cognitive impaired group (Cog.) mean age 55.36±10.2 and non-cognitive impaired group (Non-cog.) mean age 50.20± 13. The PNF and TSBT were applied three times a week, 30mins per session, for 12 months. Four research assistants were trained to assist in each treatment session. The outcome measure applied was mini-mental state examination (MMSE) for determining the neuropsychiatric status of participants at baseline and after exercise intervention at 4th month, 8th month and 12th month.
Results: The mean MMSE scores was significantly greater than the baseline values for both Cog.: (F (2.232, 109.366) = 68.671, p < 0.001 with large partial eta squared = .584 and Non. Cog.: (F (2.478, 121.409) = 5.787, p < 0.001 with large partial eta squared = .541
Conclusion: There was improvement in global cognitive status of the sub-acute stroke survivors after 12 months PNF and TSBT exercise adapted in this study.
Keywords: Stroke, cognitive impairment, proprioceptive neuromuscular facilitation, task specific balance training