Stroke is a neurovascular emergency, they are responsible for 5.7 million deaths according to the World Health Organization (WHO) [1] . They are the third leading cause of mortality after cancers and ischemic heart disease and the leading cause of acquired disability in adults [2] [3] . It is recognized that strokes are a major cause of disability. Due to the resulting limitations in activities such as walking, language and social participation [4] [5] . In working-age subjects, this disability has socioeconomic, professional and psychological consequences that can lead to depression [6] - [8] . In Congo, although the socio-professional reintegration of stroke patients is possible, it remains very limited [9] , due to the absence of dedicated support programs to help adapt workstations according to the disability presented by the patients. The aim of this work was to identify factors contributing to functional recovery and professional reintegration 3 months post-stroke.

This was a longitudinal analytical study, running from March 1^st to October 31^st, 2024, a period of 8 months, conducted in the neurology departments and the neurovascular care unit of the CHUB in Brazzaville, as well as the neurology, multidisciplinary intensive care, and emergency departments of the Loandjili and Adolphe Cisé general hospitals in Pointe-Noire.

All patients aged 18 to 55 years, hospitalized in these departments and suffering a first stroke confirmed by brain imaging, were included. Patients with a preexisting disability secondary to a non-neurological or neurological condition other than stroke were excluded from the study. The variables studied were: sociodemographic (age, sex, marital status, professional category, educational level and socioeconomic level); clinical characteristics of the stroke (reason for admission and time to admission, state of consciousness at admission: Glasgow Coma Scale (GCS), blood pressure, type of neurological deficit, severity of the stroke according to the NIHSS score, use of a physiotherapist, motor disability at discharge (Rankin score)); progressive (complications, time to initiation, motor disability and recovery time during follow-up, return to work and time to return to work after stroke).

The modified Rankin score was used to assess the disability of patients with disabilities, it is rated from 0 - 5: no disability (0 - 1), mild to moderate disability (2 - 3), severe disability (4 - 5).

Early rehabilitation was carried out in the physiotherapy department of the hospitals mentioned. It was performed at a frequency of 3 sessions per day during the acute phase of hospitalization and daily upon discharge.

For patients with mild to moderate disability (Rankin score 2 - 3):

For patients with severe disability (Rankin score 4 - 5):

A flat sort of the database was performed. The qualitative variables were presented in tables containing the absolute and relative counts. For quantitative variables, the trend (mean, median) and dispersion (standard deviation) parameters were calculated. Comparisons of proportions were made using Pearson’s Chi-square test or Fisher’s exact test when the conditions for applying the Pearson test were not met. The Chi-square test was applicable when the theoretical numbers were greater than 5. To identify factors associated with mortality, recovery and socio-professional reintegration, two types of analyses were performed:

Interpretation of hazard ratios/odds ratios:

The significance threshold was set at 5%.

Data were entered into Kobotoolbox. Data processing was performed in Excel 2019. Statistical analyses were performed using SPSS 27 software

During the study period, 553 patients were hospitalized for stroke, including 290 in Brazzaville and 263 in Pointe-Noire. Among the 553 patients, 232 met the inclusion criteria, giving a hospital frequency of stroke in young people of 42% for both cities. The hospital frequency in Brazzaville was 34.8% and in Pointe-Noire 49.8%, including 92 with an ischemic stroke (39.6%) and 104 with a hemorrhagic stroke (60.4%).

The mean age of the patients was 46.8 ± 6.9 years with extremes of 26 - 55 years. There were 123 (53%) men and 109 (47%) women, i.e. a sex ratio of 1.1.

The distribution of patients according to marital status and professional category is presented in Table 1 . Table 2 shows the distribution of patients according to educational and socioeconomic level.

Among the 232 patients, two (0.9%) patients had neither motor nor language disorders.

One hundred and thirty-three patients had hemiplegia (57.9%), 96 had hemiparesis (41.7%), 9 had dysarthria (39.1%), 80 had aphasia (38%).

At arrival, thirty-seven patients had a major stroke (15.9%), 73 a severe stroke (31.5%), 97 a moderate stroke (41.8%), 25 a minor stroke (10.8%).

The rate of recovery and professional reintegration was high in Congo. Factors associated with recovery were a low Rankin score and the achievement of early functional rehabilitation. This provides useful information to encourage and refer patients very quickly to the appropriate rehabilitation centers in order to allow good functional recovery and facilitate professional integration.