An Early Report on the Barthel Index in Niger Delta Stroke Care: A 2007–2008 Cohort Study from University of Port Harcourt Teaching Hospital

Background: Stroke is a leading cause of disability in the Niger Delta, yet systematic functional outcome data from this region remain scarce. This study evaluated the clinical utility and nurse-led feasibility of the Barthel Index (BI) at the University of Port Harcourt Teaching Hospital (UPTH), where no dedicated stroke unit existed and neuroimaging was unreliable during the study period.
Methods: A prospective cohort of 30 consecutive first-ever stroke patients was enrolled from October 2007 to March 2008. Trained ward nurses administered the BI, Mini-Mental State Examination (MMSE), and Glasgow Coma Scale (GCS) at Weeks 1, 6, and 12 post-stroke. Longitudinal changes were examined using one-way repeated-measures ANOVA with least significant difference post-hoc testing.
Results: Mean BI improved from 20.9 at Week 1 to 83.5 at Week 12 (F = 31.74, p < .001). By Week 12, 16 of 30 participants (53%) had achieved full independence (BI = 100). MMSE rose from 15.7 to 27.6 (F = 9.56, p < .001) and GCS from 10.6 to 13.9 (F = 9.72, p < .001). All 30 participants completed every assessment; each session required 5–10 minutes.
Conclusion: This cohort represents one of the earliest documented applications of the BI in Niger Delta stroke care, predating its formal Nigerian validation. Nurse-led bedside assessment was entirely feasible without specialist support. As Nigeria develops stroke unit infrastructure, these 2007–2008 recovery data provide a rare pre–stroke-unit functional baseline for the region.