{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T17:48:34Z","timestamp":1785433714818,"version":"3.56.0"},"reference-count":43,"publisher":"AOSIS","license":[{"start":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T00:00:00Z","timestamp":1779235200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Background: Effective rehabilitation is crucial for stroke survivors to regain functional independence and reduce the healthcare burden associated with disability and hospital readmission.\nAim: To evaluate the functional outcomes in patients with stroke at private rehabilitation facilities between 2006 and 2023.\nSetting: This was a retrospective cohort study of 9010 patients, post-stroke, at private rehabilitation facilities registered with the South African Board of Healthcare Funders.\nMethods: The 7-point BETA scale was used to measure inpatients\u2019 ability to perform Activities of Daily Living (ADL) in real time. Secondary analysis was conducted on ADL data sets (N = 9010) from a purposive sample of private rehabilitation facilities (n = 47). Descriptive statistics were used to determine the median functional scores of stroke patients measured by the BETA scale. Linear regression was used to compare functional gain scores by baseline patient demographics, and logistic regression for the association between functional deterioration and patient factors, and to predict risk.\nResults: Functional outcomes showed limited improvement; 40.8% of inpatients experienced deterioration, 19.5% showed no functional gain, 31.9% showed modest gain, and a small minority (&lt; 0.5%) achieved substantial functional gains. Predictors of functional outcomes included age, gender, racial demographics, facility type and stroke characteristics.\nConclusion: The findings indicate suboptimal functional outcomes in patients, post-stroke, at private rehabilitation facilities. There is a need for targeted improvements in rehabilitation practices and policy changes to enhance post-stroke functional outcomes.\nContribution: This study provides longitudinal perspectives of patients\u2019 functional outcomes post-stroke in private rehabilitation facilities and an evidence base for informing rehabilitation practice improvements.<\/jats:p>","DOI":"10.4102\/hsag.v31i0.3174","type":"journal-article","created":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T06:07:25Z","timestamp":1779170845000},"update-policy":"https:\/\/doi.org\/10.4102\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Functional outcomes post-stroke: Evidence from private rehabilitation facilities in South Africa between 2006 and 2023"],"prefix":"10.4102","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7928-1295","authenticated-orcid":false,"given":"LeeAnne","family":"Masilela","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03rp50x72","id-type":"ROR","asserted-by":"publisher"}],"name":"University of the Witwatersrand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4840-6776","authenticated-orcid":false,"given":"Hendrik","family":"Loubser","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03rp50x72","id-type":"ROR","asserted-by":"publisher"}],"name":"University of the Witwatersrand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3536-9129","authenticated-orcid":false,"given":"Nicola","family":"Plastow","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05bk57929","id-type":"ROR","asserted-by":"publisher"}],"name":"Stellenbosch University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0611-8662","authenticated-orcid":false,"given":"Daleen","family":"Casteleijn","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00g0p6g84","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Pretoria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3194-5125","authenticated-orcid":false,"given":"Judith","family":"Bruce","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03rp50x72","id-type":"ROR","asserted-by":"publisher"}],"name":"University of the Witwatersrand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2580","published-online":{"date-parts":[[2026,5,20]]},"reference":[{"key":"ref0","doi-asserted-by":"crossref","unstructured":"Adeniji, O., Adeleye, O., Akinyemi, J., Otubogun, F., Ogunde, G., Ogunrombi, M. et al., 2023, \u2018Organized multi-disciplinary stroke team care improves acute stroke outcomes in resource limited settings; Results of a retrospective study from a Nigerian tertiary hospital\u2019, Journal of Stroke and Cerebrovascular Diseases 32(10), 107307. https:\/\/doi.org\/10.1016\/j.jstrokecerebrovasdis.2023.107307","DOI":"10.1016\/j.jstrokecerebrovasdis.2023.107307"},{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Akinyemi, R.O., Ovbiagele, B., Adeniji, O.A., Sarfo, S.F., Abd-Allah, F., Adoukonou, T. et al., 2021, \u2018Stroke in Africa: Profile, progress, prospects and priorities\u2019, Nature Reviews Neurology 17(10), 634\u2013656. https:\/\/doi.org\/10.1038\/s41582-021-00542-4","DOI":"10.1038\/s41582-021-00542-4"},{"key":"ref2","doi-asserted-by":"crossref","unstructured":"Byrne, S.J., Williams, D., Patton, D., Murphy, P. & Horgan, F., 2025, \u2018The role of a stroke specialist nurse in early supported discharge and secondary prevention in the community. 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& Matizirofa, L., 2020, \u2018An analysis of recent stroke cases in South Africa: Trend, seasonality and predictors\u2019, South African Medical Journal 110(2), 92\u201399. https:\/\/doi.org\/10.7196\/SAMJ.2020.v110i2.013891","DOI":"10.7196\/SAMJ.2020.v110i2.013891"},{"key":"ref28","doi-asserted-by":"crossref","unstructured":"Rejno\u0308, A., Nasic, S., Bja\u0308lkefur, K., Bertholds, E. & Jood, K., 2019, \u2018Changes in functional outcome over five years after stroke\u2019, Brain and Behavior 9(6), e01300. https:\/\/doi.org\/10.1002\/brb3.1300","DOI":"10.1002\/brb3.1300"},{"key":"ref29","doi-asserted-by":"crossref","unstructured":"Saceleanu, V.M., Toader, C., Ples, H., Covache-Busuioc, R.-A, Costin, H.P., Bratu, B.-G. et al., 2023, \u2018Integrative approaches in acute ischemic stroke: From symptom recognition to future innovations\u2019, Biomedicines 11(10), 2617. 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R., 2023, \u2018Osuntokun award lecture 2021: Challenges of measuring the burden of stroke in Africa\u2019, Journal of Stroke & Cerebrovascular Disease 31(4), 106386. https:\/\/doi.org\/10.1016\/j.jstrokecerebrovasdis.2022.106386","DOI":"10.1016\/j.jstrokecerebrovasdis.2022.106386"},{"key":"ref39","doi-asserted-by":"crossref","unstructured":"Winstein, C.J., Stein, J., Arena, R., Bates, B., Cherney, L.R., Cramer, S.C. et al., 2016, \u2018Guidelines for adult stroke rehabilitation and recovery: A guideline for healthcare professionals from the American Heart Association\/American Stroke Association\u2019, Stroke 47(6), e98\u2013e169. https:\/\/doi.org\/10.1161\/STR.0000000000000098","DOI":"10.1161\/STR.0000000000000098"},{"key":"ref40","unstructured":"World Stroke Organization (WSO), 2022, Global stroke fact sheet."},{"key":"ref41","doi-asserted-by":"crossref","unstructured":"Zafar, H., Shahzad, N., Atiq, M.M.A., Mannan, F. & Bhatti, U., 2020, \u2018A model to determine value of care 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