The 'Bounce Back' rehabilitation programme for stroke survivors in South Africa - a case report

Introduction: Stroke is one of the global leading causes of disability, with a higher prevalence at a younger age in sub-Saharan Africa. Returning to functional status is a primary goal of rehabilitation for stroke survivors. However, the cost of intensive rehabilitation is often a barrier for the under-resourced in South Africa. Patient presentation: This article describes the individualised 'return-to-function' approach to rehabilitation and its outcomes for five stroke survivors delivered through a non-profit public-private partnership in a low-income community in South Africa. Management and outcome: A retrospective case series of stroke survivors who participated in the Bounce Back Journey (BBJ) programme between 2019 and 2021 was conducted. The beneficiaries' ages ranged from 21 to 55 years; two were females and three were males. The goals and outcomes of five stroke survivors with impairments, functional limitations and participation restrictions admitted into the BBJ programme were evaluated through standardised outcome measures. All the beneficiaries required financial support and extensive rehabilitation to return to a functional life. All showed improved outcomes in functional independence and health-related quality of life at discharge. Depressive symptoms clinically deteriorated in one patient. At discharge, all participants faced challenges finding opportunities to return to work. Conclusion: The case series demonstrates how an alternative community-based rehabilitation programme has the potential to improve functionality, health-related quality of life and mental health. Contribution: A low-cost, community-based, intensive rehabilitation programme can improve functionality, but return to work and community re-integration opportunities remain limited.