Background and Purpose: About 50–70% of individuals surviving a right hemispheric stroke will experience post-stroke unilateral spatial neglect (USN). However,  there is scanty literature on the rehabilitation of patients with USN in Nigeria.  This study aimed to evaluate the Knowledge and current practice of post-stroke unilateral spatial neglect rehabilitation amongst Nigerian physiotherapists.

Relevance: Evidence on the current pattern of  Knowledge and practice of post-stroke USN rehabilitation among Nigerian physiotherapists can heighten the need for a review of curriculum and rehabilitative policy which can positively impact on rehabilitation outcomes and practice.

Participants/subjects: Physiotherapists practicing in stroke rehabilitation units in Nigeria were recruited into this study using purposive sampling methods.

Method: This was a cross-sectional study of physiotherapists who were contacted through email, Whatsapp, SMS and physically at the annual neurorehabilitation congress. An online structured questionnaire that assessed respondents' knowledge and current practice of post-stroke unilateral spatial neglect rehabilitation was administered from November 2018 to June 2019.

Analysis: Data was analyzed using SPSS version 16. The data were summarized using descriptive statistics and factors associated with physiotherapists’ knowledge and practice was assessed using inferential statistics.

Results:

Of the 543 Physiotherapists contacted, 140 (25.8% return rate) respondents completed the questionnaire while 94 respondents practiced at a stroke rehabilitation unit. The mean age was 31 (range = 28 - 36 ) years, and the majority of respondents were males (69.89%), worked in a hospital setting (61.70%) and had post-graduate certification in neurological Physiotherapy (64.13%). Most participants (70.2%) demonstrated good knowledge (knowledge score>50%)  of post-stroke USN rehabilitation. Educational Level(P=.009) and post-graduate certification in neurological physiotherapy (P=.002) were significantly associated with the respondent’s increased knowledge of post-stroke unilateral spatial neglect rehabilitation. It was found that for every increase from one educational level to the next, the average knowledge score increased by 4.43% (95% CI= 1.95-6.92). Also, those who had certification in neurological physiotherapy had a knowledge score that was higher than the average for those without certification in Neurological physiotherapy by 9.70% (95% CI = 3.73-15.67). Constraint-induced movement therapy (71.3%, n=67) and limb activation exercise (43.6%, n=41) were the commonly used rehabilitation methods for post-stroke unilateral spatial neglect rehabilitation in Nigeria while Albert's test (18.1%, n=17) was the most utilized screening tool for USN. About 54.3 % ( n=44) of respondents do not use any standardized screening tool in assessing patients for USN. A majority (92.5 %) of respondents re-evaluated a patient for unilateral spatial neglect after an initial evaluation and most physiotherapists ( 96.3%) referred stroke patients to the multidisciplinary stroke team.

Conclusions: The majority of participants had good knowledge of post-stroke USN rehabilitation. Participants' knowledge increased as they attain higher education levels. Conventional methods of stroke rehabilitation are commonly used for post-stroke unilateral spatial neglect rehabilitation in Nigeria. Results emphasize the need for specialist rehabilitation training for physiotherapists and the incorporation of standardized outcome measures in practice.