Participation Restriction due to Arm and Leg Motor Impairment after Stroke Rehabilitation in the Tamale Metropolitan Area, Ghana

Frank Twum, Joslin Alexei Dogbe, Anthony Kweku Edusei, Joseph Ampratwum


Purpose: The study was conducted to examine the relationship between arm and leg motor impairment in stroke survivors and participation restriction, post rehabilitation, within the Tamale metropolis.

Method: The participants were 102 stroke survivors from the Tamale metropolitan area, who had undergone at least 3 months of rehabilitation. Upper limb motor assessment was followed by lower limb motor assessment based on the Manual Muscle Test. Levels of participation restriction were measured using the London Handicap Scale. Correlation analysis of motor impairment and participation restriction were done using Spearman rank correlation analysis.

Results: The mean age of post-stroke participants was 62.08 years (95% CI= 59.77-64.39), with men comprising 67.65% and 32.35% women. The Spearman rank correlation co-efficient between arm motor impairment and participation was 0.8343, depicting a strong positive relationship between the aforementioned variables. The correlation between leg motor impairment and participation yielded 0.8013. Conversely, leg motor impairment was found to have a stronger relationship with participation restriction in comparison to arm motor impairment.

Conclusion and Implications: The strong relationship between limb motor impairment and participation restriction suggests that clinicians and disability experts involved in rehabilitation should take cognisance of the social implication of motor impairment in order to make informed decisions. Further to this, arm and leg assistive devices could be useful in reducing the levels of participation restriction among persons with stroke within the Tamale metropolis.

Limitations: A major limitation is that motor impairment was assessed solely on the ability to perform voluntary movement (muscle power). Sensory disturbances and motor coordination difficulties also have the potential to influence participation restriction, so the exclusion of stroke survivors who are unable to communicate implies that external validity of the research is limited.


Disability; upper limb; lower limb; manual muscle scale; London handicap scale

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