Browsing by Author "Ekechukwu, E. N. D."

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    Perceived Barriers and Facilitators of Return to Driving Among a Sample of Nigerian Stroke Survivors – A Qualitative Study
    (Springer International Publishing, 2021) Nwankwo, K. O.; Olaleye, O. A.; Hamzat, T. K.; Ekechukwu, E. N. D.
    Stroke affects driving ability and as such impedes mobility, independence, freedom and quality of life. Return to driving after stroke serves as an integral part for community reintegration and improved quality of life. Driving is considered critical for continued independence, employment and recreation among stroke survivors. There was therefore the need to better understand the perceived facilitators and barriers to driving among stroke survivors with pre-stroke driving history. This study seeks to better understand the perceived facilitators of and barriers to return to driving after stroke so as to enable proper outcome in patient management and policy formulation. This is a qualitative phenomenological app roach using in-depth focus group discussion (FGD) was employed. Six stroke survivors (5 males; 1 female) aged 58.0 ± 7.9 years participated in the FGD. Half (50%) of the participants had returned to driving. Seven themes were generated for the barriers as well as facilitators of return to driving after stroke. Findings from this study suggests that majority of the facilitators of return to driving are intrinsic factors. Majority of stroke survivors wish that they could be able to stop being dependent on their caregivers for their activities of daily living (ADL) which could invariably lead to activity limitation and participation restriction. Attention should be paid on the pre-morbid driving status of stroke survivors so as to enhance the facilitators of return to driving and minimize the barriers to return to driving after stroke.
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    Pragmatic Solutions for Stroke Recovery and Improved Quality of Life in Low- and Middle-Income Countries—A Systematic Review
    (Frontiers Media S.A., 2020) Ekechukwu, E. N. D.; Olowoyo, P.; Nwankwo, K. O.; Olaleye, O. A.; Ogbodo V. E.; Hamzat, T. K.; Owolabi, M. O.
    Background: Given the limited healthcare resources in low and middle income countries (LMICs), effective rehabilitation strategies that can be realistically adopted in such settings are required. Objective: A systematic review of literature was conducted to identify pragmatic solutions and outcomes capable of enhancing stroke recovery and quality of life of stroke survivors for low- and middle- income countries. Methods: PubMed, HINARI, and Directory of Open Access Journals databases were searched for published Randomized Controlled Trials (RCTs) till November 2018. Only completed trials published in English with non-pharmacological interventions on adult stroke survivors were included in the review while published protocols, pilot studies and feasibility analysis of trials were excluded. Obtained data were synthesized thematically and descriptively analyzed. Results: One thousand nine hundred and ninety six studies were identified while 347 (65.22% high quality) RCTs were found to be eligible for the review. The most commonly assessed variables (and outcome measure utility) were activities of daily living [75.79% of the studies, with Barthel Index (37.02%)], motor function [66.57%; with Fugl Meyer scale (71.88%)], and gait [31.12%; with 6min walk test (38.67%)]. Majority of the innovatively high technology interventions such as robot therapy (95.24%), virtual reality (94.44%), transcranial direct current stimulation (78.95%), transcranial magnetic stimulation (88.0%) and functional electrical stimulation (85.00%) were conducted in high income countries. Several traditional and low-cost interventions such as constraint-induced movement therapy (CIMT), resistant and aerobic exercises (R&AE), task-oriented therapy (TOT), body weight supported treadmill training (BWSTT) were reported to significantly contribute to the recovery of motor function, activity, participation, and improvement of quality of life after stroke. Conclusion: Several pragmatic, in terms of affordability, accessibility and utility, stroke rehabilitation solutions, and outcome measures that can be used in resource-limited settings were found to be effective in facilitating and enhancing post-stroke recovery and quality of life.