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Neurorehabil Neural Repair. 2018 Sep;32(9):821-833. doi: 10.1177/1545968318796341. Epub 2018 Sep 4.

Course of Social Participation in the First 2 Years After Stroke and Its Associations With Demographic and Stroke-Related Factors.

Author information

1
1 Maastricht University Medical Center, Netherlands.
2
2 Limburg Brain Injury Center, Maastricht, Netherlands.
3
3 Utrecht University and De Hoogstraat Rehabilitation, Utrecht, Netherlands.
4
4 University of Groningen, Netherlands.
5
5 La Trobe University, Melbourne, Australia.
6
6 Florey Institute of Neuroscience and Mental Health, Melbourne, Australia.
7
7 University Utrecht, Netherlands.
8
8 Maastricht University, Netherlands.

Abstract

BACKGROUND:

Many persons with stroke experience physical, cognitive, and emotional problems that contribute to restrictions in social participation. There is, however, a lack of knowledge on the long-term course of participation over time post-stroke.

OBJECTIVE:

To describe the time course of participation up to 2 years post-stroke and to identify which demographic and stroke-related factors are associated with this time course.

METHODS:

This was a multicenter, prospective cohort study following 390 persons with stroke from hospital admission up to 2 years (at 2, 6, 12, and 24 months). Multilevel modeling with linear and quadratic time effects was used to examine the course of the frequency of vocational and social/leisure activities, experienced restrictions, and satisfaction with participation.

RESULTS:

The frequency of vocational activities increased up to 1 year post-stroke and leveled off thereafter. Older and lower-educated persons showed less favorable courses of participation than younger and higher-educated persons, respectively. The frequency of social/leisure activities decreased post-stroke. Participation restrictions declined up to 1 year post-stroke and leveled off thereafter. Persons dependent in activities of daily living (ADL) kept experiencing more restrictions throughout time than independent persons. Satisfaction with participation increased slightly over time.

CONCLUSIONS:

Changes in participation occurred mostly in the first year post-stroke. Particularly older and lower-educated persons, and those dependent in ADL showed less favorable courses of participation up to 2 years post-stroke. Clinicians can apply these findings in identifying persons most at risk of long-term unfavorable participation outcome and, thus, target rehabilitation programs accordingly.

KEYWORDS:

demography; prognosis; social participation; stroke

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