Early Mobilization and Physical Activity Improve Stroke Recovery: A Cohort Study of Stroke Inpatients in Kisumu County Referral Hospitals, Kenya

Abstract

Early mobilization in acute stroke care is highly recommended in a range of developed countries policy; however, in developing countries like Kenya, lack of evidence seems to hinder formulation and implementation of policy guideline on early mobilization in acute stroke care. Therefore, to estimate the safe optimal time for early mobilization of stroke patients in Kenya, we conducted a prospective cohort study in two purposively selected health facilities in Kisumu County, Kenya. About 100 stroke patients admitted in medical wards (mean age 59.1±2.3 years, females 61%) were recruited. Barthel Index’ tool was used to assess recovery and physical activity levels. It comprised of scoring scale ranging from 0-100. The participants were categorized as follows: Patients who score between 0 – 30 were considered as mildly recovered, 31 - 60 as moderately recovered and patients who score from 61 – 100 were regarded as fully recovered. Multiple logistic regression model was used to compute adjusted ORs (AOR) of early mobilization and Barthel Index variable, adjusting for age, gender and type of stroke. Early mobilization improves patient recovery. Participants in early mobilization group were more like to independently feed, groom, dress, use toilet, use wheel chair and climb stairs with help compared to late mobilization (p <0.05). Most (76%) participants who were exposed to high physical activity had full recovery than the (5%) bones in low physical activity (p< 0.001). This study provides evidence that early mobilization and high physical activity improves stroke patient recovery.