# Post‐Stroke Limitations on Activities of Daily Living and Associated Factors in Public Tertiary Hospitals in Amhara Regional State, Ethiopia: A Multicenter Cross‐Sectional Study

## TL;DR

This study finds that over half of stroke survivors in Ethiopia struggle with daily tasks, linked to depression, right-brain strokes, and lack of early therapy.

## Contribution

The study provides new data on post-stroke ADL limitations in Ethiopia and identifies specific risk factors unique to the region.

## Key findings

- 58.25% of stroke survivors had limitations in basic activities of daily living.
- Right hemisphere stroke and lack of early physiotherapy were strongly associated with ADL limitations.
- Depressive symptoms and use of mobility aids also significantly correlated with reduced ADL performance.

## Abstract

Stroke survivors often face challenges with basic activities of daily living (ADLs), which can compromise their health by making it difficult to perform everyday tasks independently. These limitations frequently lead to sedentariness, increased morbidity, and mortality. Although the prevalence of post‐stroke limitations in basic ADLs varies significantly among studies, there is a general lack of data, particularly from Ethiopia. This lack of research hinders a comprehensive understanding of the extent of ADL limitations among stroke survivors in the region and their associated health outcomes.

To assess the extent of post‐stroke limitation in basic ADL and identify associated factors among stroke survivors.

An institution‐based cross‐sectional study was conducted from April 1 to June 30, 2022. We selected 400 participants using systematic random sampling. The Barthel Index was used to assess limitations on ADL post‐stroke participants. We checked for multicollinearity and model fitness. Variables with a p‐value below 0.25 in bivariable regression were included in a multivariable logistic regression analysis, considering a p‐value below 0.05 as statistically significant.

The overall prevalence of post‐stroke limitations in basic ADL was 58.25%. Significant associations were found with symptoms of depression (odds ratio [OR] = 1.69, 95% confidence interval [CI] = 0.88–2.49; p < 0.05), right hemisphere stroke (OR = 1.79, 95% CI = 3.58–5.01; p < 0.05), absence of early physiotherapy (OR = 1.88, 95% CI = 0.19–1.58; p < 0.05), and use of mobility aids (OR = 1.81, 95% CI = 0.17–1.44; p < 0.05).

The study highlights the high prevalence of limitations in basic ADL following a stroke, with significant associations found with factors such as stroke in the right hemisphere, lack of early physiotherapy, use of mobility aids, and depressive symptoms. These findings emphasize the need for early rehabilitation interventions, particularly physiotherapy, and addressing mental health to improve recovery outcomes. Healthcare providers should focus on individualized care plans that include physical and psychological support to better manage post‐stroke limitations and enhance the quality of life for stroke survivors.