African Journal of Public Health and Health Systems | 26 December 2015
Protocol for a Study on the Impact of a Structured Physical Rehabilitation Programme on Functional Outcomes for Stroke Survivors at Mulago National Referral Hospital, Uganda
D, a, v, i, d, M, u, w, a, n, g, u, z, i, ,, G, r, a, c, e, N, a, l, u, b, e, g, a, ,, N, a, k, a, t, o, K, i, g, o, z, i
Abstract
Stroke is a leading cause of adult disability in Uganda, creating substantial burden. Access to structured, evidence-based rehabilitation in low-resource settings is often limited, which may contribute to suboptimal functional recovery for survivors. This protocol describes a study to evaluate a structured rehabilitation programme at a major national referral hospital. The primary purpose is to assess the impact of a structured, multidisciplinary physical rehabilitation programme on functional outcomes for stroke survivors at Mulago National Referral Hospital. Specific objectives are to: 1) compare functional mobility and independence in activities of daily living between intervention and usual care groups; 2) evaluate patient and carer satisfaction with the programme; and 3) identify barriers and facilitators to its implementation. A mixed-methods, quasi-experimental design with a control group will be employed. A sample of adult stroke survivors admitted to the hospital will be allocated to either the structured rehabilitation programme or usual care. The intervention is a 12-week, therapist-led programme based on task-oriented training. Quantitative data on functional outcomes will be collected using the modified Rankin Scale and Barthel Index at baseline, post-intervention, and at a three-month follow-up. Qualitative data will be gathered via focus group discussions with a subset of participants and carers to explore their experiences. As this is a study protocol, no empirical findings are available. The results will present quantitative comparisons of functional scores and qualitative themes regarding programme acceptability. It is hypothesised that the intervention group will show a clinically meaningful improvement, defined as a 20% greater increase in Barthel Index scores compared to the control group. The study will generate evidence on the feasibility and potential effectiveness of a structured rehabilitation model in a Ugandan public hospital setting. The conclusion will discuss whether the programme significantly improves functional outcomes and can be integrated into routine care. Recommendations will be formulated for clinical practice and hospital policy based on the study's findings regarding effectiveness, implementation barriers, and facilitators. Suggestions for future research may also be provided. stroke rehabilitation, functional outcomes, Uganda, quasi-experimental study, mixed methods, physiotherapy. This protocol contributes a detailed methodological framework for evaluating a context-specific rehabilitation intervention. It addresses a critical evidence gap regarding structured stroke rehabilitation in low-resource hospital settings in sub-Saharan Africa.