FREQUENCY OF NON-MOTOR SYMPTOMS IN POST-STROKE PATIENTS AT LADY READING HOSPITAL PESHAWAR

Abstract

Background: Stroke is a major public health problem worldwide, contributing to significant morbidity and mortality. While motor deficits have traditionally been the focus of post-stroke care, non-motor symptoms (NMS) such as sleep disturbances, mood disorders, urinary dysfunction, and cognitive decline are also highly prevalent and negatively impact recovery and quality of life.

Objective: To determine the frequency of non-motor symptoms in post-stroke patients at Lady Reading Hospital, Peshawar.

Methods: This cross-sectional study was conducted in the Department of Medicine, Lady Reading Hospital, from November 2024 to April 2025. A total of 170 post-stroke patients aged 20–80 years were enrolled using non-probability consecutive sampling. Patients with pre-existing neurological or psychiatric conditions were excluded. Data were collected through structured face-to-face interviews using a standardized questionnaire covering nine domains of NMS, including cardiovascular, sleep, gastrointestinal, urinary, sexual, cognitive, mood, perceptual, and miscellaneous symptoms.

 Results: The mean age of participants was 59.2 ± 10.8 years, with 57.6% males and 69.4% ischemic strokes. The most prevalent NMS were urinary dysfunction (81.2%), sleep disturbances (71.8%), mood disorders (60.0%), fatigue and musculoskeletal pain (64.7%), and cognitive symptoms (54.1%). Sexual dysfunction was present in 51.8%, while gastrointestinal problems occurred in 43.5%. Females reported significantly higher rates of sleep disturbances (80.6% vs. 65.3%, p = 0.03) and urinary dysfunction (88.9% vs. 75.5%, p = 0.02), whereas males had higher sexual dysfunction (63.3% vs. 36.1%, p = 0.001). Mood symptoms decreased with longer stroke duration (p = 0.04). Patients with hypertension and diabetes showed significantly higher rates of NMS compared to those without comorbidities.

Conclusion: It is concluded that non-motor symptoms are highly prevalent among post-stroke patients in Peshawar, with sleep disturbances, urinary dysfunction, and mood changes being the most frequent. These findings emphasize the need for comprehensive, multidisciplinary rehabilitation strategies that address both motor and non-motor symptoms to improve recovery and quality of life in stroke survivors.