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After a stroke incident, physical inactivity is common. People with stroke may perceive several barriers to performing physical activity (PA). This study aimed to document the PA level and understand the barriers and facilitators to engaging in PA for community-dwelling stroke survivors in Benin, a lower middle-income country. A cross-sectional study was conducted in three hospitals in Benin. Levels of PA were recorded by means of the Benin version of the International Physical Activity Questionnaire long form (IPAQ-LF-Benin), which is validated for stroke survivors in Benin. The perceived exercise facilitators and barriers were assessed by the Stroke Exercise Preference Inventory-13 (SEPI-13). A descriptive analysis and associations were performed with a Confidence Interval of 95% and

The prevalence of physical inactivity after stroke is high and exercise training improves many outcomes. However, access to community training protocols is limited, especially in low-income settings.To investigate the feasibility and efficacy of a new intervention: Circuit walking, balance, cycling and strength training (CBCS) on activity of daily living (ADL) limitations, motor performance, and social participation restrictions in people after stroke.Forty-six community-dwelling individuals with chronic stroke who were no longer in conventional rehabilitation were randomized into an immediate CBCS group (IG; initially received CBCS training for 12 weeks in phase 1), and a delayed CBCS group (DG) that first participated in sociocultural activities for 12 weeks. In phase 2, participants crossed over so that the DG underwent CBCS and the IG performed sociocultural activities. The primary outcome was ADL limitations measured with the ACTIVLIM-Stroke scale. Secondary outcomes included motor performance (balance: Berg Balance Scale [BBS], global impairment: Stroke Impairment Assessment Set [SIAS] and mobility: 6-minute and 10-metre walk tests [6MWT and 10mWT] and psychosocial health [depression and participation]). Additional outcomes included feasibility (retention, adherence) and safety.ADL capacity significantly improved pre to post CBCS training (ACTIVLIM-stroke, +3,4 logits, p0.001; effect size [ES] 0.87), balance (BBS, +21 points, p0.001; ES 0.9), impairments (SIAS, +11 points, p0.001; ES 0.9), and mobility (+145 m for 6MWT and +0.37 m/s for 10mWT; p0.001; ES 0.7 and 0.5 respectively). Similar improvements in psychosocial health occurred in both groups. Adherence and retention rates were 95% and 100%, respectively.CBCS was feasible, safe and improved functional independence and motor abilities in individuals in the chronic stage of stroke. Participation in CBCS improved depression and social participation similarly to participation in sociocultural activities. The benefits persisted for at least 3 months after intervention completion.PACTR202001714888482.

This study aimed to assess the prevalence of chronic low back pain (CLBP) and related biopsychosocial factors in urban and rural communities in Benin.This is a population-based observational cross-sectional survey. An interviewer-administered electronic questionnaire was used to collect information on demographic, socio-economic, behavioral, and psychological factors relating to CLBP risk factors and medical history of participants. The numeric pain rating scale and the Beck Depression Inventory were used to assess pain intensity and the level of depression, respectively. Bivariate analyses were performed to investigate the association between sociodemographic, behavioral, and psychological factors and CLBP. Sequential multiple regression analyses were subsequently performed to predict the occurrence of CLBP.A total of 4320 participants, with a mean age ± SD of 32.9 ± 13.1 years, of which 40.7% were females and 50.1% from an urban area, were enrolled in the study. We found a global prevalence rate of CLBP of 35.5% [95% CI 34.1-36.9%]. The prevalence in urban areas was 30.68% [95% CI 28.9-32.8%]) while 40.2% was found in rural areas [95% CI 38.1-42.2%]). Age (p 0.001), level of education (p = 0.046), marital status (p 0.001), working status (p 0.003), tobacco use (p 0.016) and regular physical activity (p 0.011) were associated with CLBP. In urban areas, only the level of education was able to predict the prevalence of CLBP (RThis study showed a high prevalence of CLBP among urban and rural communities in Benin. Age, level of education, marital status, and working status were significantly associated with CLBP in Benin.

This publication was supported by the Foundation Universitaire de Belgique (Belgian University Foundation).

BACKGROUND: The PM-Scale was developed specifically to assess participation in individuals after stroke based on the concepts contained in the International Classification of Functioning, Disability and Health. However, this measure is only available in English and French. OBJECTIVE: To translate and cross-culturally adapt the PM-Scale to Brazilian Portuguese, followed by the validation and testing of reliability of the translated version. METHODS: The translation process followed standard guidelines. Preliminary test-retest reliability was determined using the intraclass correlation coefficient (ICC(2,1)). The Rasch model was employed to analyse the validity, unidimensionality, invariance, and internal consistency of the Brazilian version of the PM-Scale. RESULTS: The final translated version of the PM-Scale presented appropriate semantic, idiomatic, cultural, and conceptual equivalence. The preliminary analysis revealed excellent intra-observer and inter-observer reliability (ICC(2,)(1) = 0.91; 95%CI: 0.83, 0.95 and ICC(2,)(1) = 0.81; 95%CI: 0.64, 0.89, respectively). The analysis of the Rasch model revealed only one erratic item. An excellent overall fit was found for items (mean ± SD = 0.01 ± 1.02) and adequate fit was found for persons (mean ± SD = 1.16 ± 0.88). Internal consistency was considered adequate (person separation index = 1.77, reliability = 0.76). No significant invariance was found with regards to the personal characteristics of the sample (p > 0.05). CONCLUSION: The Brazilian version of the PM-Scale is a valid, unidimensional, linear, reliable scale for measuring participation in stroke survivors and can be administered in less than five minutes.

Background The burden of stroke is high in sub-Saharan Africa; however, few data are available on long-term mortality. Objective To estimate over one-month stroke case fatality in sub-Saharan Africa. Methods A systematic review and meta-analysis were performed according to meta-analysis of observational studies in epidemiology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO protocol: CRD42020192439), on five electronic databases (PubMed, Science direct, AJOL, EMBASE, and Web of Sciences). We searched all studies on stroke case fatality over one month in sub-Saharan Africa published between 1st January 2000 and 31st December 2019. Results We included 91 studies with a total of 34,362 stroke cases. The one-month pooled stroke case-fatality rate was 24.1% [95% CI: 21.5–27.0] and 33.2% [95% CI: 23.6–44.5] at one year. At three and five years, the case-fatality rates were respectively 40.1% [95% CI: 20.8–63.0] and 39.4% [95% CI: 14.3–71.5] with high heterogeneity. Hemorrhagic stroke was associated with a higher risk of mortality at one month, but ischemic stroke increased the risk of mortality over six months. Diabetes was associated with poor prognosis at 6 and 12 months with odds ratios of 1.64 [95% CI: 1.22–2.20] and 1.85 [1.25–2.75], respectively. Conclusion The stroke case fatality over one month was very high, compared to case fatalities reported in Western countries and can be explained by a weak healthcare systems and vascular risk factors.

Background: Balance impairment is the predominant risk factor for falls in stroke survivors. A fear of falling after stroke can contribute to sedentary lifestyles, increased disability and risk of recurrence, leading to poor quality of life. Objective: To determine the frequency and factors associated with balance impairments amongst stroke survivors at the University Hospital of Parakou. Method: This cross-sectional study included adult stroke survivors. Stroke survivors after discharge were enrolled at the University Hospital of Parakou between 01 January 2020 and 30 September 2020. Balance impairments were measured by using the Berg Balance Scale (BBS), the Timed Up and Go (TUG) and the Get Up and Go (GUG) tests. Results: A total of 54 stroke survivors were included, with a mean age of 58.37 ± 12.42 years and a male predominance of 68.52%. The mean BBS score was 36.87 ± 14.34 with a minimum and a maximum of 10 and 56, respectively. Thirteen (24.07%) had balance impairments (BBS score ≤ 20), 34 (62.96%) had a TUG score ≥ 14 s (abnormal), 9 (16.67%) presented a moderate risk of falling and 6 (11.11%) presented high risk of fall with the GUG test. Post-stroke duration (odds ratio [OR] = 0.04; 95% CI: 0.04–0.30; p < 0.01), severity of disability (OR = 8.33; 95% CI: 1.03–67.14; p = 0.03) and the number of physiotherapy sessions (OR = 0.18; 95% CI: 0.03–0.93; p = 0.02) were significantly associated with balance impairments. Conclusion: Our results showed that almost one quarter of stroke survivors after discharge at the University Hospital of Parakou had balance impairments. Post-stroke duration, severity of disability and the number of physiotherapy sessions were significantly associated with balance impairments. Clinical implications: [AQ1] Balance should be regularly assessed in people post-stroke. Further studies should document the content of rehabilitation and any rehabilitative efforts to improve balance in people post-stroke in Benin.

Background: Sub-Saharan Africa faces a high burden of stroke due to growing of their risk factors. We aimed to estimate the prevalence of stroke risk factors and to identify associated factors in the district of Titirou in Parakou (northern Benin), in 2016.Methods: It was a cross-sectional study. It included adults living in Titirou and having given their consent. A door-to-door survey was performed from 15 march to 15 July 2016 in each neighbourhood or village until the expected number reached. We recorded the socio-demographic data, medical histories, anthropometric and blood pressure measures using WHO steps approach. Prevalences of stroke risk factors were calculated and a logistic regression was done to identify factors associated with metabolic risk factors.Results: A total of 4671 participants was included with a mean age of 27.7±12.9 years and a sex ratio of 0.97. Prevalences of behavioural risk factors were estimated at: 17.2% of alcohol consumption, 21.5% of low fruits and vegetables consumption, 51.1% of low physical activity practice, and 3.5% of smoking. Metabolic risk factors prevalence’s amounted to: 8.7% of obesity, 7.1% of high blood pressure, 1.7% of self-reported diabetes and 2.2% of dyslipidaemia. Age (pConclusion: The study showed high prevalences of low physical activity practice and obesity. Targeted local interventions focused on these factors should be conducted for primary prevention of stroke in this community, or even beyond in Benin.

Background and purpose: Chronic low back pain (CLBP) is an increasing burden worldwide. The biopsychosocial factors associated with CLBP have not yet been investigated in Burundi. The aim of this study was to investigate the biopsychosocial factors that influence the CLBP-related outcomes of self-reported pain intensity, limitations in activities of daily living (ADLs), and social participation (SP) restrictions in a Burundian sample population.Methods: We carried out a cross-sectional study of 58 adults with non-specific CLBP from Bujumbura city. Measures of pain intensity, ADL limitations, SP restrictions, and biopsychosocial factors were analyzed with descriptive, inferential, and correlational statistics.Results: The biopsychosocial factors found to be associated with CLBP outcomes were body mass index (BMI), education level, gender, healthcare coverage, depression, trunk muscles endurance, and perceived exertion. Self-reported pain intensity was found to be significantly associated with a sub-university education level, depressiveness, high perceived exertion, low spine extensor muscles endurance, and low abdominal muscles endurance (p range, p range, Conclusions: This study provides evidence of biopsychosocial factor associations with CLBP-related pain, ADL limitations, and SP restrictions in Burundi. Significantly associated factors were consistent with factors that have been associated with CLBP outcomes in high-income countries, with the addition of lack of healthcare coverage as a significant factor in Burundi. Evidence-based management of CLBP in Burundi should incorporate a biopsychosocial model.

COVID-19 has abruptly disrupted healthcare services; however, the continuity of rehabilitation could be guaranteed using mobile technologies. This review aims to analyze the feasibility and effectiveness of telehealth solutions proposed to guarantee the continuity of rehabilitation during the COVID-19 pandemic. The PubMed, Cochrane Library, Web of Science and PEDro databases were searched; the search was limited to randomized controlled trials, observational and explorative studies published up to 31 May 2022, assessing the feasibility and effectiveness of telerehabilitation during the COVID-19 pandemic. Twenty studies were included, for a total of 224,806 subjects: 93.1% with orthopedic complaints and 6.9% with non-orthopedic ones. The main strategies used were video and audio calls via commonly available technologies and free videoconferencing tools. Based on the current evidence, it is suggested that telerehabilitation is a feasible and effective solution, allowing the continuity of rehabilitation while reducing the risk of infection and the burden of travel. However, it is not widely used in clinical settings, and definitive conclusions cannot be currently drawn. Telerehabilitation seems a feasible and safe option to remotely deliver rehabilitation using commonly available mobile technologies, guaranteeing the continuity of care while respecting social distancing. Further research is, however, needed to strengthen and confirm these findings.

To review and quantify the effects of walking training for the improvement of various aspects of physical function of people with chronic stroke. We conducted a systematic search and meta-analysis of randomized controlled trials (RCTs) of chronic stroke rehabilitation interventions published from 2008 to 2020 in English or French. Of the 6476-screened articles collated from four databases, 15 RCTs were included and analyzed. We performed a meta-regression with the total training time as dependent variable in order to have a better understanding of how did the training dosage affect the effect sizes. Treadmill walking training was more effective on balance and motor functions (standardized mean difference (SMD)=0.70[0.02, 1.37], p = 0.04) and 0.56[0.15, 0.96], p = 0.007 respectively). Overground walking training improved significantly walking endurance (SMD = 0.38[0.16, 0.59], p < 0.001), walking speed (MD = 0.12[0.05, 0.18], p < 0.001), participation (SMD = 0.35[0.02, 0.68], p = 0.04) and quality of life (SMD = 0.46[0.12, 0.80], p = 0.008). Aquatic training improved balance (SMD = 2.41[1.20, 3.62], p < 0.001). The Meta-regression analysis did not show significant effect of total training time on the effect sizes. Treadmill and overground walking protocols consisting of ≥30 min sessions conducted at least 3 days per week for about 8 weeks are beneficial for improving motor impairments, activity limitations, participation, and quality of life in people with chronic stroke.Implications for rehabilitationTreadmill walking training is effective for improving balance and motor functions.Overground walking training improved significantly walking endurance, walking speed, participation and quality of life.Treadmill and overground walking protocols consisting of ≥30 min sessions conducted at least 3 days per week for about 8 weeks are beneficial for improving motor impairments, activity limitations, participation, and quality of life in patient with chronic stroke. Treadmill walking training is effective for improving balance and motor functions. Overground walking training improved significantly walking endurance, walking speed, participation and quality of life. Treadmill and overground walking protocols consisting of ≥30 min sessions conducted at least 3 days per week for about 8 weeks are beneficial for improving motor impairments, activity limitations, participation, and quality of life in patient with chronic stroke.

International audience; WHO defines physical activity (PA) as any bodily movement produced by skeletal muscles that requires energy expenditure (EE). The purpose of this study was to compare the EE estimations by ActiGraph GT3X+ with a gold standard measurement, the portable gas analyser in a set of 3 different PAs. This cross-sectional study involved 56 participants, age range (years, [min, max]: young people [20, 33], older adults [65, 83]). Participants completed a single session of three experimental PAs including biking, treadmill walking, and treadmill running. Each participant wore five GT3X+ triaxial accelerometers and a portable gas analyser used as the gold standard measurement. The GT3X+ were placed on the wrists, the waist (centred at the pelvis), and the ankles. ActiGraph GT3X+ and MetaMax3B records were investigated through intraclass correlation coefficient. Magnitude of measurement error was estimated using Effect Size. The GT3X+ wrist and GT3X+ waist underestimated EE regardless of the PA type. The GT3X+ ankles strongly overestimated EE during biking (mean bias = 489 ± 392%) and walking (mean bias = 106 ± 58%), while it underestimated EE during running (mean bias = -47 ± 27%). The ActiGraph GT3X+ does not provide accurate EE estimates across a range of placement locations during moderate and high-intensity PA.

Supplemental material, sj-pdf-2-wso-10.1177_1747493021990945 for Stroke case fatality in sub-Saharan Africa: Systematic review and meta-analysis by Thierry Adoukonou, Oyéné Kossi, Pervenche Fotso Mefo, Mendinatou Agbétou, Julien Magne, Glwadys Gbaguidi, Dismand Houinato, Pierre-Marie Preux and Philippe Lacroix in International Journal of Stroke

Supplemental material, sj-pdf-3-wso-10.1177_1747493021990945 for Stroke case fatality in sub-Saharan Africa: Systematic review and meta-analysis by Thierry Adoukonou, Oyéné Kossi, Pervenche Fotso Mefo, Mendinatou Agbétou, Julien Magne, Glwadys Gbaguidi, Dismand Houinato, Pierre-Marie Preux and Philippe Lacroix in International Journal of Stroke

Supplemental material, sj-pdf-1-wso-10.1177_1747493021990945 for Stroke case fatality in sub-Saharan Africa: Systematic review and meta-analysis by Thierry Adoukonou, Oyéné Kossi, Pervenche Fotso Mefo, Mendinatou Agbétou, Julien Magne, Glwadys Gbaguidi, Dismand Houinato, Pierre-Marie Preux and Philippe Lacroix in International Journal of Stroke

International audience; Le fardeau des accidents vasculaires cérébraux (AVC) est assez lourd pour les pays en développement et plus particulièrement en Afrique subsaharienne. La mortalité des AVC est assez élevée dans cette région et pouvait s’expliquer par le système de santé, des facteurs culturels et même des spécificités des AVC dans cette population. Les données sur la mortalité à court terme (moins d’un an) sont nombreuses et indiquent un taux très élevé à celui rapporté ailleurs dans le monde. Les rares études sur la mortalité à un an et après indiquent une mortalité entre 31,5 % et 67 % de taux de mortalité à un an. Ce taux dépasse 75 % après 5 ans. Le niveau de handicap après un AVC est aussi étudié et est globalement plus lourd que celui rapporté ailleurs. Plusieurs facteurs expliquent ce pronostic notamment l’âge, le délai d’amission trop tardif, l’hypertension artérielle, l’importance du déficit neurologique, le type d’AVC et les complications à la phase aiguë. Les causes de décès restent dominées par la récidive d’AVC, les causes cardiaques et infectieuses. Il importe donc une sérieuse organisation des soins à la phase aiguë et une prévention secondaire efficace. Il est à souligner que seule une érection de véritable filière neurovasculaire nationale et une prise en charge correcte de l’hypertension artérielle permettraient d’améliorer significativement ce pronostic.

Supplemental Digital Content is available in the text, Purpose: Walking and mind-body therapies (MBTs) are commonly recommended to relieve pain and improve function in patients with chronic low back pain (CLBP). The purpose of this study was to compare the effectiveness of walking and MBTs in CLBP. Methods: We included randomized controlled trials (RCTs) comparing walking or MBTs to any other intervention or control in adults with CLBP. Studies were identified through PubMed, Cochrane Library, PsycINFO, Scopus, and ScienceDirect databases. The research was limited to studies published in English and French between January 2008 and December 2018. Two reviewers independently selected the studies, extracted data, and assessed studies quality using the Physiotherapy Evidence Database (PEDro) scale. Statistical analyses were performed under a random-effects model. We analyzed pain and activity limitation, with the calculation of standardized mean differences and 95% confidence intervals for the different treatment effects. Results: Thirty one randomized controlled trials involving 3193 participants were analyzed. Walking was as effective as control interventions in the short-term and slightly superior in the intermediate term with respect to pain (Standardized mean differences (SMD) = –0.34; 95% CI, –0.65 to –0.03; P = .03) and activity limitation (SMD = –0.30; 95% CI, –0.50 to –0.10; P = .003). In contrast, yoga was more effective than control interventions in the short term in terms of pain (SMD = –1.47; 95% CI, –2.26 to –0.68; P = .0003) and activity limitation (SMD = –1.17; 95% CI, –1.80 to –0.55; P = .0002). Yoga was no longer superior to the control interventions for pain at the 6-month follow-up. Conclusion: MBTs, especially yoga, seem to be more effective in the short term, and walking seems to be more effective in the intermediate term, for the relief of pain and activity limitation in patients with CLBP. A combination of walking and MBTs fits the biopsychosocial model and might be valuable therapy for CLBP throughout follow-up due to combined effects.

Introduction Stroke is one of the most common causes of high mortality rates in Africa with many unknown aspects around its prognosis. In this study we aim to describe stroke characteristics and in-hospital mortality of stroke in Parakou. Methods This is a retrospective cohort study including all stroke patients admitted to the Department of Neurology at Parakou Teaching Hospital from January 1, 2013 through to December 31, 2019. Clinical data, vascular risk factors, stroke subtype and outcome data were recorded. The in-hospital case-fatality and its associated factors were determined. The study was approved by the Local Ethics Committee of Biomedical research and has been registered under the unique indentifying number researchregistry5687 and is available at https://www.researchregistry.com/browse-the-registry#home/ Results Stroke cases represented 51.5% of all patients. There were 372 patients included in the study with a mean age of 58.2 ± 14.2 years. The sex ratio was 1:3. Ischemic stroke accounted for 40.3%, intracerebral hemorrhage 30.4%, and unknown 29.3%. The main vascular risk factors were hypertension (69.1%), alcoholism (23.9%) and diabetes mellitus (16.9%). The mean NIHSS at admission was 9.4 ± 5.7 and the length of hospital stay was 9.0 ± 7.3. The most common complications recorded during the acute phase were swallowing disorders (10.2%), pneumonia (9.1%) and urinary tract infections (8.3%). The in-hospital case fatality was 6.2% and was associated with loss of consciousness (p = 0.0001), high NIHSS on admission (p = 0.001), fever (p = 0.0001), swallowing disorders (p = 0.001) and leukocytosis (p = 0.021). On discharge, 27.6% were independent and 97.8% were on antihypertensive drugs. Conclusion The in-hospital stroke mortality was close to that reported by other studies in Africa., Highlights • Subsaharan Africa (SSA) had a high burden of stroke. • The stroke unit and stroke specialists can reduce the in-hospital mortality. • We reported the low in-hospital mortality of stroke compared to those reported in SSA. • The early detection and management of acute complications may reduce the acute complications of stroke.

Aim: To test the validity of Borg’s 6–20 rating of perceived exertion scale in assessing the exertion intensity over a multi-activity session in young and older adults.Materials and methods: This cross-sectional study included 56 healthy participants. All participants underwent a single session of activities including working on a computer, treadmill walking, biking, and treadmill running. Results: Results showed a non-significant correlation between the overall perceived exertion and energy expenditure in young people (Rho=−0.05, p=0.75) and in older adults (Rho=−0.05, p=0.78) for the whole session. However, results showed that older adults perceived significantly higher exertion compared to young people while working on a computer, walking and running, whereas they presented lower energy expenditure while resting and working on a computer. Conclusions: Combining the perceived exertion method with other commonly used methods to estimate exercise intensity would be recommended for older adults.

International audience; The burden of stroke is high in Africa, but few data are available on the long-term outcome of strokes in this area. Aim: We aimed to study the long-term outcome of stroke survivors in Parakou from 2012 to 2018. Methods of Study: It was a cohort study and included 247 stroke patients admitted to the University Hospital of Parakou from January 1, 2012 to April 30, 2018. Each patient was followed up for at least 1 year. The modified RANKIN scale was used to evaluate patients. Verbal autopsy was used to ascertain the cause of death. The survival probability was estimated using the Kaplan-Meier method. Predictors of mortality were estimated using the Cox proportional model and the hazard ratio (HR) and their 95% confidence intervals were determined. The data were analyzed using Stata Software. Results: The mean age was 58.1 ± 13.4 years with a sex ratio of 1.12. Among stroke survivors, the mortality was 10.1% at 3 months, 11.7% at 6 months, 15.4% at 1 year, 21.5% at 3 years, and 23.5% at 5 years. The probability of survival after a stroke was 66.5% at 5 years. Factors associated with mortality were age with adjusted HR 1.4 (1.2-1.7) for each 10 years, male sex with aHR 2.3 (1.2-4.6), history of hypertension with aHR 2.0 (1.0-4.1) and the severity of the initial neurological impairment National Institute of Health Stroke Scale with aHR 1.1 (1.0-1.2) for each 1 point. The main causes of death were recurrent stroke, infectious diseases, and cardiac disease. The proportion of patients with functional disability was 53.8% at 1 year. The quality of life was generally impaired in terms of physical health, personal environment, and finances. Conclusions: The long-term prognosis of stroke patients in Parakou is poor. It requires urgent action to reduce this burden.

Introduction Stroke is a major public health problem with a high burden in Sub-Saharan Africa. We aimed to determine the prevalence of stroke in Titirou in Parakou. Methods It was a cross-sectional study using a door-to-door survey in Titirou (Parakou) from 15 march to 15 October 2016 and included 4671 adults. We did a two stages survey. In the first stage the World Health Organization (WHO) tool for the diagnosis of stroke in community was used. In the second phase all suspected cases underwent neurological exam and sometimes brain CT-scan . The WHO definition was used for the diagnosis of stroke. We recorded the socio-demographic data and the vascular risk factors. The prevalence was standardized on age according to the WHO type population. Multiple logistic regression was done to identify associated factors and estimate the adjusted prevalence ratio (aPR) and their 95% confidence interval (CI). Results The mean age of the subjects was 27.7 ± 12.9 years with a sex ratio of 0.97. After screening 161 were suspected and 54 confirmed cases, the overall prevalence of stroke in Titirou was 1.156 per 100,000 inhabitants [95% CI: 0.850 to 1.426]. The age-standardized prevalence of stroke was 3223 cases per 100,000 inhabitants. The associated factors were age (aPR 1.7 [1.5–1.9] for 10 years), history of hypertension (aPR: 64.8 [46.1–108.9]), diabetes mellitus (aPR: 4.5 [1.6–12.3]), low consumption of fruits and vegetables (aPR: 2.3 [1.2–4.4]), history of heart disease (aPR: 6.0 [2.6–13.7]), family history of stroke (PR: 4.6 [2.1–10.0]). Among the 54 subjects who had a stroke 10 were able to perform the brain CT-Scan: 40% were hemorrhagic and 60% ischemic stroke . Conclusion Our study showed a high prevalence of stroke in Titirou and suggested urgent action for prevention.

To appraise available International Classification of Functioning, Disability and Health (ICF)-based tools for the measurement of participation after stroke and to examine their applicability in the African sociocultural context. Pubmed/Medline, Science Direct, Cochrane Library, and Hinari databases were systematically searched. The literature search was limited to studies published in the English or French language from January 2001 up to May 2019. Two reviewers independently screened all identified studies and selected eligible articles. Disagreements about inclusion or exclusion of studies were resolved by consensus. Two reviewers independently extracted the psychometric properties of each instrument using the Consensus-based Standard for the Selection of Health Measurement Instruments checklist and examined the methodological quality of each selected study using the MacDermid checklist. A total of 1030 articles were systematically reviewed for relevance, yielding 22 studies that met inclusion criteria. These studies were related to nine participation tools. The MacDermid scores ranged from 13 to 21 out of 24. The number of investigated psychometric properties and the number of ICF participation domains covered by each tool varied among studies. This systematic review revealed nine ICF-based tools for the measurement of participation after stroke. We examined the content of these tools and provided valuable information that can be used to guide researchers in Africa in their selection of the most appropriate tool for the measurement of participation after stroke.

Objective To build a model of prediction of social participation of community-dwelling stroke survivors in Benin at 1 month, 3 months, and 6 months. Design An observational study with evaluations at 1 month, 3 months, and 6 months poststroke. Correlational analyses and multivariate linear regressions were performed. Setting Outpatient rehabilitation centers in Benin. Participants A volunteer sample of 91 stroke patients was enrolled at baseline; 64 (70%) patients completed all the study (N=64): 70% male and 52% right hemiparesis. Intervention Not applicable. Main Outcome Measures Participants were evaluated with the Participation Measurement Scale, ACTIVLIM-Stroke (activities of daily living [ADL]), Stroke Impairment Assessment Set, 6-minute walk test, Hospital Anxiety and Depression Scale, and the modified Rankin Scale. Results The significant predictors of social participation after controlling the confounders were the following: at 1 month ADL (0.4 [0.3, 0.6]) and depression (‒0.6 [‒0.8, ‒0.2]) with total model R2=0.44; at 3 months ADL (0.58 [0.4, 0.7]) and depression (‒0.58 [‒0.5, ‒0.7]) with total model R2=0.65; and at 6 months ADL (0.31 [0.2, 0.5]), impairments (‒0.82 [‒0.5, ‒0.7]), and depression (‒0.94 [‒0.8, ‒0.2]) with total model R2=0.78. Conclusions Using socioculturally tailored tools, the present study identified ADL performance (ACTIVLIM-Stroke), depression (Hospital Anxiety Depression Scale), and overall impairments (Stroke Impairment Assessment Set) as the significant determinants of social participation (Participation Measurement Scale) poststroke in Benin. These findings will be a valuable resource for rehabilitation stakeholders in evaluating interventions, programs, and policies designed to encourage social participation for stroke patients.

International audience; Background: The burden of stroke is very high in sub-Saharan Africa. The identification of the factors influencing poor outcome can help to reduce this burden. Objective: To study factors influencing the prognosis of stroke at Parakou. Methods: It was a prospective study conducted over two periods: inclusion period between 1st January and 30 June 2013; monitoring period of survivors between 1st July and 30 September. All consecutive patients admitted in the hospitals for stroke in the study period were included. The functional outcomes were assessed by the RANKIN scale (RANKIN > 2). Epi-info version 7 and SPSS version 16 were used for the statistical analyses. Results: We recruited 85 patients; mean age was 52 ± 15 years. The housewives and the unschooled represented respectively 33% and 65%. The mortality rates at 1 and 3 month were respectively 27% and 32%. Factors associated with mortality were female gender, stroke severity, disorders of consciousness, hyperthermia and hyperglycemia at admission, overweight, pneumonia, anemia, hyperleucocytosis, higher total and LDL serum cholesterol levels at 1 month; housewife status and pneumonia were associated at 3 month. 47% of survivors were independent at 1 month. Stroke severity and length of hospital stay were associatedwith disability at 1 month whereas previous stroke and disability history, stroke severity, weight and length of hospital stay were related with 3month poor functional outcome. Conclusion: This study showed the poor outcome of stroke patients in Parakou which were influenced by many factors. Taking account of these factors in the strategies of care in the acute phase may improve the prognosis of stroke patients.

International audience; Peu de données sont disponibles sur la participation à la vie sociale chez les personnes âgées victimes d’accident vasculaire cérébral (AVC). Ce travail a été réalisé dans la ville de Parakou au Bénin en 2017. Il s’est agi d’une étude cas-témoins ayant inclus 33 sujets âgés ayant fait un AVC et 66 témoins appariés sur l’âge, le sexe et le milieu de résidence. Les informations sur la participation, le handicap global et de la capacité cognitive des sujets ont été recueillies à partir de différentes échelles : la Participation Measurement Scale, le Rankin et le questionnaire Community Screening Instrument for Dementia. L’âge moyen des participants était 61±8 ans. La participation moyenne chez les sujets post-AVC était de 2,34±1,58 logit et chez les sujets témoins de 3,21±1,21 logit (t=−2,4 ; p=0,02). Cette différence se situe principalement au niveau des situations en rapport avec la vie communautaire, sociale et civique. L’intégrité cognitive était le facteur déterminant de la participation aussi bien chez les cas que chez les témoins. Dans notre étude, l’AVC contribue à une restriction de participation à la vie sociale chez les personnes âgées.

Objective: To investigate responsiveness of the Participation Measurement Scale (PM-Scale) for the measurement of participation of stroke survivors. Design: A 6-month observational study with 3 evaluation time points. Responsiveness of the PM-Scale was investigated over a period of 6 months. Setting: Rehabilitation centers. Participants: Stroke survivors (N Z64); mean age ! SD, 56.9!12.6 years; sex, 45 men (70%). Interventions: Not applicable. Main Outcome Measures: Participants were evaluated using the PM-Scale. The modified Rankin Scale was used to categorize the overall disability level for each participant. Results: The mixed-effect model analysis showed a significant difference in the participation over time (c2Z35.04; dfZ2; P

International audience; Objective: To develop a valid stroke-specific tool, named the Participation Measurement Scale (PM-Scale), for the measurement of participation after stroke. Design: Observational study and questionnaire development. Setting: Outpatient rehabilitation centers. Participants: Patients with stroke (N=276; mean age, 58.5±11.1y; 57% men). Interventions: Not applicable. Main outcome measures: Participants completed a 100-item experimental questionnaire of the PM-Scale. Items were scored as "not at all," "weakly," or "strongly." The Hospital Anxiety and Depression Scale was used to evaluate depression, and the modified Rankin Scale was used to categorize the severity of disability on the basis of observation. Results: After successive Rasch analyses using unrestricted partial credit parameterization, a valid, unidimensional, and linear 22-item scale for the measurement of participation was constructed. All 22 items fulfilled the measurement requirements of overall and individual item and person fits, category discrimination, invariance, and local response independence. The PM-Scale showed good internal consistency (person separation index, .93). The test-retest reliability of item difficulty hierarchy (r=.96; P

International audience; Introduction: La migraine est une maladie neurologique fréquente en population, source de handicap et classée 13ème des affections les plus handicapantes par l’OMS. L’objectif de cette étude était d’étudier la prévalence de la migraine à Titirou en 2017. Méthodes: Il s’est agi d’une étude transversale de type porte-à-porte menée sur 2065 sujets âgés de 18 à 65 ans. L’enquête a été effectuée sur une période de 4 mois allant du 10 avril au 05 août 2017. Les critères diagnostiques de l’International Headache Society (IHS) de 2013 ont servi de base pour le diagnostic de la migraine. Les informations sociodémographiques, le poids et taille et les données relatives à la fréquence et l’intensité des céphalées furent collectés. Les données ont été saisies, traitées et analysées grâce au logiciel Epi Info version 2.2.0.165. Résultats: Il y avait une prédominance masculine avec un sex-ratio de 1,41. Les sujets étaient âgés de 18 à 65 ans avec une moyenne d’âge de 31,87±8,37ans. La prévalence des céphalées était de 63,49%. La prévalence de la migraine à Titirou était de 3,82% [IC95% : (3,06%-4,72%)] (79 sur les 2065). Les facteurs associés à la migraine étaient l’âge (p=0,0026), le sexe (p=0,0001), le niveau d’instruction (p=0,0039), la profession (p

International audience; Objective: Stroke is a major public health problem in developing countries. However, few studies have quantified the functional recovery of stroke patients in sub-Saharan Africa. This study examined the functional recovery of stroke patients in the Republic of Benin. Methods: A total of 68 patients with acute stroke were recruited from hospitals and health centres in Benin. Patients were evaluated at enrolment and 1, 3 and 6 months post-stroke. The ACTIVLIM-Stroke scale, Barthel Index, and modified Rankin Scale were used to assess activity limitations, functional autonomy, and overall level of disability, respectively. Results: Over the 6-month follow-up period, 18 patients died and 9 dropped out. Overall, the 3 measures highlighted progressive and significant functional recovery during the first 6 months. At enrolment, the mean score on ACTIVLIM-Stroke was 16% (standard deviation (SD) 9), indicating that patients were almost totally dependent and unable to perform most activities of daily living. At 6 months, the mean score for activity limitation reached 67% (SD 15) and most patients were able to perform some basic tasks easily. Patients had difficulty with tasks requiring walking and remained unable to perform certain activities requiring manual dexterity. Conclusion: The study sample showed significant functional recovery (~50%) during the first 6 months post-stroke. We recommend the integration of group-based brisk walking into a cost-effective rehabilitation programme as a suitable way to increase functional recovery of chronic stroke patients in sub-Saharan Africa after hospital discharge.

Les accidents vasculaires cerebraux constituent un probleme majeur de sante publique. Objectif Etudier la charge reelle des AVC au Benin. Methodes Les auteurs ont realise une revue des donnees publiees sur les AVC au Benin et ont degage les donnees epidemiologiques, cliniques et economiques contribuant a exprimer la charge des AVC au Benin. Toutes les publications des differents auteurs sur les AVC y compris les monographies sont etudiees pour degager les indicateurs epidemiologiques. Resultats La prevalence des AVC en population generale etait respectivement de 460 et 1156 pour 100 000 habitants a Cotonou et a Parakou. Ils constituent 46,9 % a 53,4 % des hospitalisations en neurologie. Les AVC ischemiques representent 50,6 % et pres de 10 % des patients n’ont pas acces au scanner. La mortalite est respectivement de 16,7 % en phase hospitaliere et de 27,1 % ; 31,8 % et 35,5 % a 1, 3 et 12 mois apres l’AVC. Le cout direct hospitalier de leur prise en charge est respectivement de 316 810,3 CFA et 515 000 CFA a Parakou et Cotonou. Parmi les survivants une bonne recuperation fonctionnelle est observee apres 6 mois. Les comorbidites telles l’epilepsie, la depression et la demence viennent alourdir cette charge. Discussion Des efforts de reorganisations de soins malgre l’inexistence d’UNV sont en cours et il existe une bonne filiere de soins de suite et de reeducation. Conclusion La charge des AVC est tres elevee et appelle a des actions urgentes de prevention et des etudes complementaires epidemiologiques.