Sāmoan stroke survivors wanted for study

Every hour, a person in New Zealand has a stroke.

Pacific people are almost twice as likely to suffer a stroke, compared to New Zealand Europeans, and are having them eight years earlier.

A study on ethnic differences showed Pasifika have worse post-stroke outcomes, and face inequities in accessing medication.

Physiotherapist Eliana Viali was surprised and concerned by the lack of research on Sāmoan people who have had a stroke, and she is conducting a study for her masters degree at Otago University.

“It seems that there are questions that have no answers in the research.”

When trying to research ways to support clients, Viali said there were “huge gaps” in targeted academic literature, and some of the techniques she was taught in New Zealand “didn’t gel” with the Sāmoan population.

“In New Zealand, when I’m asking people to do physical activity in a certain way, it makes sense to them … then I would try to talk to Sāmoan stroke survivors or Sāmoan people in general about physical activity, and it just felt like there was a bit of a mismatch.”

A stroke can happen when a blood clot blocks blood supply to your brain. Photo/File

The research aims to understand exercise and movement for Sāmoan people who have experienced a stroke.

“To us as Sāmoan people, we understand our ways of being and knowing and doing, but for the people who are providing services for us, they don't know how we operate, why we operate, those kinds of things.

“So that's basically what my research is, it's asking Sāmoan stroke survivors what they think, how they feel about physical activity, and about how stroke has affected them.”

After graduating with a Bachelor of Physiotherapy in 2019, Viali got to work with a range of cases in private practice and hospital patients in Sāmoa.

“So from day one or day two of their stroke or amputation to about three weeks later, that was the period where I was seeing them, but then in private, I would see people who might have had strokes two or three years ago, and they wanted help because they didn’t know where else to go.”

Otago University research fellow Troy Ruhe said this study would be the first of its kind.

“This research begins an avenue of a nuanced and culturally specific approach to stroke recovery.

“It also provides Eliana with an opportunity to co-create meaningful solutions with her Sāmoan community.”

Part of the study will look at physical activity or movement following a stroke.

Viali said this did not have to be sports or going to the gym, but she would want to hear from the Sāmoan community about what worked for them.

“Other physical activity programs that I've seen where Pacific people are more engaged, they often are run by Pacific people, they often really value prayer and faith as a core value in physical activity programs, and there's almost always a cup of tea or food afterwards.”

Health conditions such as high blood pressure, heart disease, being overweight, and diabetes all increase the risk of a stroke, as well as family history.

Kiribati has the highest rate of stroke in the world. Closer to home, stroke survivors include actor David Fane and entertainer Cindy of Sāmoa.

Eliana Viali treating Samoa Archery athletes at the 2023 Pacific Games in the Solomon Islands. Photo/Supplied

More representation needed in the workplace

Only two per cent of physiotherapists in New Zealand are from Pacific communities. Viali was one of four physios in Sāmoa when she worked there, and said many people did not realise what their work entailed.

“When they watch rugby and one of the guys gets injured, you see someone run onto the field with ‘physio’ on their back and they think, ‘Oh, that's what a physio is, they run onto the field and they do rugby stuff’.

“But no, it's when we work in the hospital, we help people who have just come out of surgery to help them regain their mobility.

"We help people who have been affected by stroke or who have had a stroke, who have lost some of the strength or sensation in their limbs and we help train them and help get them back to a more stable sense of mobility.”

She said there was some overlap with traditional massage, or fofō, to decrease pain and promote healing of soft tissue in the muscle.

"Massage is one of the ways in which physios do this, along with dry needling, foam rolling, active and passive stretching, and through exercise prescription."

Viali has travelled across the Pacific to teach strength and conditioning courses with the Oceania National Olympic Committee and was at the Pacific Games in the Solomon Islands last year as Team Samoa’s archery physio.

"Whenever I am treating clients, I aim to think and treat holistically, and always try to find the balance between cultural beliefs and scientific approaches to health and wellness."

Watch the full interview with Eliana Viali on PMN Samoa.