Impact of a Supervised Walking Programme on Quality of Life After Stroke in Gabon: An 8-Week Hospital Based Randomized Controlled Trial in Libreville
Impact d'un Programme de Marche Supervisée sur la Qualité de Vie Après un AVC au Gabon : Un Essai Randomisé Contrôlé de 8 Semaines en Milieu Hospitalier à Libreville
DOI:
https://doi.org/10.67260/hra.v4i8.7921Keywords:
Stroke, supervised walking, quality of life, rehabilitation, randomized controlled trialAbstract
RÉSUMÉ
Introduction. L’accident vasculaire cérébral (AVC) demeure une cause majeure de handicap et d’altération de la qualité de vie, particulièrement en Afrique subsaharienne, où les données sur la réadaptation restent limitées. Cette étude a pour objectif d’évaluer l’impact d’un programme structuré de marche sur la qualité de vie de patients en phase chronique d’AVC. Méthode. Un essai contrôlé randomisé, en groupes parallèles et en simple insu, a été réalisé au Centre Hospitalier Universitaire de Libreville d’octobre à décembre 2023. Des patients ayant un AVC datant de 3 à 12 mois ont été randomisés entre un groupe Intervention bénéficiant d’un programme de marche supervisée (30 minutes, trois séances par semaine pendant 8 semaines) et un groupe Contrôle recevant la prise en charge habituelle. Le critère de jugement principal était l’évolution du score global de la Stroke Impact Scale (SIS). Les critères secondaires comprenaient les scores NIHSS et MMSE. Résultats. Trente-trois patients ont été analysés (groupe intervention : 17 et groupe contrôle : 16). Le groupe intervention a présenté une amélioration significative du score SIS (p = 0,018), avec un gain médian supérieur à celui du groupe contrôle (45 versus 9,3 ; p = 0,014). Aucune différence significative n’a été observée entre les groupes pour les scores NIHSS et MMSE. Conclusion. Un programme structuré de marche supervisée améliore significativement la qualité de vie des patients en phase chronique d’AVC. Facile à mettre en œuvre et peu coûteuse, cette intervention pourrait être intégrée aux programmes de réadaptation dans notre contexte.
ABSTRACT
Introduction. Stroke remains a leading cause of disability and impaired quality of life worldwide, particularly in sub-Saharan Africa, where evidence on post-stroke rehabilitation is still limited. This study aimed to evaluate the impact of a structured supervised walking program on the quality of life of patients with chronic stroke. Method. A single-blind, parallel-group randomized controlled trial was conducted at the University Hospital Center of Libreville, Gabon, from October to December 2023. Patients with stroke occurring 3 to 12 months before enrollment were randomly assigned to either an intervention group, which received a supervised walking program (30 minutes per session, three sessions per week for 8 weeks), or a control group receiving usual care. The primary outcome was the change in the overall Stroke Impact Scale (SIS) score. Secondary outcomes included the National Institutes of Health Stroke Scale (NIHSS) and the Mini-Mental State Examination (MMSE) scores. Results. Thirty-three patients were included in the final analysis (17 in the intervention group and 16 in the control group). The intervention group showed a significant improvement in the overall SIS score (p = 0.018), with a greater median gain than the control group (45 vs. 9.3; p = 0.014). No significant between-group differences were observed for the NIHSS or MMSE scores. Conclusion. A structured supervised walking program significantly improves quality of life in patients with chronic stroke. As a simple and low-cost intervention, it could be incorporated into post-stroke rehabilitation programs in resource-limited settings.
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Copyright (c) 2026 Nsounda AA, Gnigone PM, Mboumba C, Nyangui Mapaga J, Diouf Mbourou NE, Mambila Matsalou GA, Saphou Damon MA, Ndao Eteno ME, Kouna Ndouongo P
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