| dc.description.abstract | Musculoskeletal deformities following stroke cause significant disability among stroke survivors.Deformities such as equinovarus, claw toes, etc. are amenable to surgical correction resulting in improved functional outcome. The burden of stroke at Mulago Hospital is high and accounts for a high proportion of in-patient admissions and out-patient consultations. A number of these patients present with musculoskeletal deformities. However, the prevalence and patterns of musculoskeletal deformities following stroke have hitherto not been documented, resulting in challenges in their management.
Study objective
The objective of the study was to establish the prevalence, patterns and factors associated with musculoskeletal deformities occurring in stroke patients.
Methods
This was a descriptive cross-sectional study, carried out at Mulago Hospital in stroke patients
admitted to the neurology ward, and attending the neurology clinic and physiotherapy
department. A total of 105 patients were enrolled. Data on demographics, relevant history and
physical examination was obtained and recorded using a questionnaire, following approval from the research ethics committee.
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Results
The study found the prevalence of musculoskeletal deformity to be high at 74.3%. Of the
participants, 67.95% had both upper and lower limbs affected, 24.365 had upper limb only
affected and only 7.69% had lower limb only affected. The study found that the commonest
musculoskeletal deformity was shoulder stiffness, occurring in 70.5% of participants and the
least common were claw toes, elbow extension and forearm supination, occurring in 1.28% of
participants. Other musculoskeletal deformities included; forearm pronation(48.7%), elbow
flexion(43.6%), thumb-in-palm(35.9%),wrist flexion(34.6%), clenched fist(16.7%), shoulder
subluxation(11.5%), hip adduction(30.8%), equinovarus(24.4%), equinus(23.1%), knee
flexion(12.8%), varus(12.8%) hip flexion(6.4%) and knee extension(2.25%). The main factor
associated with musculoskeletal deformities was age above 60 years (p value 0.02, OR 3.27,
95%CI 1.17-9.19).
Conclusion
Stroke is associated with a high burden of musculoskeletal deformities in our setting. These
musculoskeletal deformities are diverse and involve both upper and lower limbs, with the upperlimb affected more. Stroke patients above the age of 60 years are at an increased risk of
developing musculoskeletal deformities. | en_US |
