I am not aware of any internationally-published institutional guidelines or protocol. 

However, there is a very nice recent review by Rhoda last year concluding that these cohort of its should not be different in any way from same cohort in developed countries, with the exception of physical environment barriers.

http://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-015-1057-z

I know of a researcher (Physiotherapist)  from the  University of Zimbabwe who has developed a protocol for training of caregivers of stroke survivors if that helps? 

I do have some protocols I developed for stroke survivors in Nigeria.

I will greatly appreciate if you could be kind enough to share the protocols you developed for stroke survivors in Nigeria to see how we can learn from your situation. My interest is to promote one protocol which can be user friendly for African Rehabilitation Professional.

Thank you so much Khair for your your response which is very much appreciated. I have been following Rhoda's publications concerning rehabilitation of stroke survivors in Africa. Her write-ups have been helpful for African researchers in terms of understanding the need for rich and acceptable protocols. However, some of the problems are just too obvious to such an extent that using such protocols could mean skipping some of the things because in some of our countries, stroke units are non-existent among many other things essential for the management of stroke survivors. Most of our people end up being managed in communities and very few reach hospitals that can hardly manage them.

Thank you so much Khair for your your response which is very much appreciated. I have been following Rhoda's publications concerning rehabilitation of stroke survivors in Africa. Her write-ups have been helpful for African researchers in terms of understanding the need for rich and acceptable protocols. However, some of the problems are just too obvious to such an extent that using such protocols could mean skipping some of the things because in some of our countries, stroke units are non-existent among many other things essential for the management of stroke survivors. Most of our people end up being managed in communities and very few reach hospitals that can hardly manage them.

Thanks Jermaine for your response which has been greatly appreciated. Can you kindly connect me to the researcher who has developed the protocol for caregivers since most of our stroke survivors are cared for by caregivers.

Here are some references that may be helpful:

1)Abdullahi, A., Shehu, S., and Dantani, B.I (2014). Feasibility of High Repetitions of Tasks Practice during Constraint Induced Movement Therapy in an Acute Stroke Patient. International Journal of Therapy and Rehabilitation, 21(4): 190-195 DOI: http://dx.doi.org/10.12968/ijtr.2014.21.4.190,

2)Abdullahi, A., Shehu, S.Abdurrahman, Z and Bello, B. Determination of Optimal Dose of Tasks Practice during Constraint Induced Movement Therapy in a Stroke Patient with Severe Upper Limb Pain.Indian Journal of Physiotherapy and Occupational Therapy - An International Journal 01/2015; 9(1):198. DOI: 10.5958/0973-5674.2015.00039.8

3)Abdullahi, A. (2014). Is time spent using constraint induced movement therapy an appropriate measure of dose? A critical literature review. International Journal of Therapy and Rehabilitation, 21(3): 140-146

4)Abdullahi, A. and Shehu, S. (2014). Standardizing the Protocols of Constraint Induced Movement Therapy in Patients within 4 months post-stroke: A Pilot Randomized Controlled Trial. International Journal of Physical Medicine and Rehabilitation, 2:4. Doi:10.4172/2329-9096.100025

Best wsihes

Thank you so much for your great help. This has been helpful. Kind regards

You are most welcome!

Dear Margaret

A colleague (PhD student) is presently developing Clinical Practice Guidelines specifically for Physiotherapy in Stroke Rehabilitation in South Africa.   

The American CPG's was published this year - I have attached a copy.

Winstein CJ, Stein J, Arena R, Bates B, Cherney LR, Cramer SC,

Deruyter F, Eng JJ, Fisher B, Harvey RL, Lang CE, MacKay-Lyons M, Ottenbacher KJ, Pugh S, Reeves MJ, Richards LG, Stiers W, Zorowitz RD; on

behalf of the American Heart Association Stroke Council, Council on Cardiovascular and Stroke Nursing, Council on Clinical Cardiology, and Council on

Quality of Care and Outcomes Research. Guidelines for adult stroke rehabilitation and recovery: a guideline for healthcare professionals from the American

Heart Association/American Stroke Association. Stroke. 2016;47:XXX–XXX. DOI: 10.1161/STR.0000000000000098.

Dear Andoret,

Thank you so much for the information availed to me. It has been greatly appreciated. I am happy that your colleague is developing a protocol for South Africa. I am sure the reason for that protocol development is because what is there in literature cannot actually answer to the needs of our stroke survivors here in Africa. I did a review article titled: The Best Time to Start Stroke Rehabilitation: A Review of the Evidence in Resource Adequate and Resource Constrained Settings. I strongly feel as much as we want to meet standards that are essential to produce better outcomes in Stroke Management, the experience in Africa is quite complicated. Most of these excellent protocols take into consideration the Acute Management that takes place in the stroke units and then later move to early rehabilitation. Therefore, in my own opinion, I feel the majority end up in most of our rural health centers, clinics and a few go to district and central hospitals and very few to Special hospitals. It is imperative to consider including what happens at grass root to the highest level hospital. Find attached the review paper mentioned above.

Dr. Margaret Mweshi

Dear Margaret

I agree 100% with you. The patient journey in private and public health settings also differs in South Africa resulting in different challenges starting in the acute phase and continues to the chronic phase.

Thank you for the article, much appreciated.

Kind regards

Andoret 

Difficult quenstion because I am not familair with Africa, But in the Netherlans I have work in an nursing home and that was in the beginning an search what are the most important goals. And that is always the same independency !

We have an observationform that we use to search what are therapeutic possibilities , I will try to link it.

GR.

jan van de Rakt 

Thank you so much Jan for your great contribution. Your input has been greatly appreciated. I know that your country is very much advanced when it comes to management of Stroke Survivors. Life in Africa is very much different and the non availability of the basic requirements for stroke rehabilitation makes clinical work difficult and prevents clinicians from providing evidence of the impact of interventions given. Nursing homes are non-existent in most African countries.

Margaret 

I know from my sister and thier husband when the are working in Zambia how difficult it is. But when I started in the netherlands in 1975 there was in nursing homes no facilitation to exercises people with stroke. That has now change but I have learn to exercise with simple things. Working with stroke patients is an way of learning thinks again but also give the body an exercise that is heavy. My favorite is task specific resistance therapy in combination with learning technique as differentiaal learning and Bobath 

I have on research gate my articles place about diagonals and there I described how the treatment for stroke patient from the beginning can be done with the learning and task specific strengthening together.

Strengthening of the affected hip can be done by giving resistance to the other leg in the swing phase and it gives an better walking pattern 

Succes

greeting 

jan 

Dear Jan,

Thanks for your input and your professional contribution. I am happy to hear the changes you have noted since you started working in nursing homes. The concept of of nursing homes is not so user friendly in Africa with slightly different anthropological values. Community Based Programs are more acceptable in most African countries no wonder Home Based Care programs have been successful.

I am sure training community workers on basic things can help in the rehabilitation process of those that cannot reach big hospitals.

Good Luck!

Margaret