Social participation of stroke patients: a bibliometric analysis

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 Social participation of stroke patients: a bibliometric analysis

Jiaqing Yan^1,2Yancheng Wang^1,2Liang Zhang^1,2Ping Chen¹Nini Yang¹Hongbo Zhang^1*

• ¹Department of Nursing, Chongming Hospital Affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, China
• ²Graduate School, Shanghai University of Traditional Chinese Medicine, Shanghai, China

Objective: Research on social functioning rehabilitation in stroke patients has received significant attention. In this study, we performed a bibliometric analysis using CiteSpace to examine publications focuses on post-stroke social participation between 2000 and 2025.

Methods: Literature related to social participation of stroke patients was retrieved from the Web of Science Core Collection from January 1, 2000, to March 28, 2025, and the number of articles, countries, institutions, authors, references, and keywords were visualized and analyzed using Microsoft Office Excel and CiteSpace software.

Results: The final analysis included836 publications, demonstrating a steady increase in annual publications over the 25-year period. Among contributing authors, Ng, Shamay S. M. demonstrated the highest productivity (20 publications). The United States and La Trobe University were the leading contributing countries and institutions. “Archives of Physical Medicine and Rehabilitation” was the most influential journal with a total of 600 citations (impact factor 3.6 in 2024). High-frequency keywords include “social participation,” “quality of life,” and “community integration.”

Conclusion: This 25-year bibliometric analysis of post-stroke social participation research identifies priority areas for future studies.

Introduction

The epidemiological burden of stroke, the second leading cause of mortality and third leading cause of disability worldwide, continues to rise (1). The Global Burden of Disease Study reports 12 million incident strokes annually worldwide, where 70–80% of survivors develop chronic functional impairments (1, 2). These impairments go beyond motor, cognitive, and linguistic deficits, severely limiting patients’ ability to perform daily activities and fulfill social roles. Notably, nearly 50% of stroke survivors still exhibit substantial participation problems1-year post-stroke, highlighting the progression from biological damage to limitations in social functioning (3, 4). In 2001, the World Health Organization introduced the International Classification of Functioning, Disability and Health (ICF), formally integrating societal-level participation as core metric for evaluating rehabilitation outcomes. This framework designated social participation as a research priority and a critical indicator of functional and prognostic recovery (5). Levasseur et al. defined social participation as a person’s involvement in activities that provide interaction with others in society or the community through analysis of 43 studies and expert consensus (6, 7).

Emerging evidence demonstrates significant associations between social participation levels and multidimensional health outcomes, including physical domains (motor function, communication deficits, cognitive impairments), psychological status (depression, motivation), and long-term quality of life. Crucially, social participation is recognized as the most robust independent predictor of rehabilitation outcomes (8, 9). Longitudinal studies indicate that low social participation is associated with elevated suPAR levels, a marker of chronic inflammation, suggesting a potential causal link. Elevated systemic inflammatory markers are linked to poor functional outcomes and increased mortality post-stroke (10–12). With the paradigm shift of the rehabilitation medicine model to a comprehensive “biopsychosocial” framework, the scope of social participation research has gradually expanded, and the relevant publications have demonstrated exponential growth (13). Given the growing recognition of social participation as a central outcome in stroke rehabilitation, it becomes crucial to understand how research in this area has evolved over time. However, existing studies focus on the current status, influencing factors, or intervention validation, while systematic analyses of knowledge architecture, disciplinary evolution, and international collaboration patterns remain understudied.

Traditional literature reviews primarily emphasize content analysis but often fail to identify emerging research hotspots and collaborative networks. Bibliometric analysis, conversely, is a quantitative methodology grounded in mathematics and statistics. This approach extracts metadata (authors, countries, institutions, keywords, cited references) from publications via analytical software, mapping a field’s macro-level landscape and effectively exploring its disciplinary evolution (14, 15). Bibliometrics has gain extensive application across medical disciplines, including complementary and alternative medicine (16), oncology (17), infectious diseases (18), nursing (19), and encephalopathy (20). This study employs bibliometric methods coupled with CiteSpace (version 6.2. R3), a scientometric visualization tool, to provide a panoramic analysis of global research dynamics in the field of stroke social participation, aiming to address current knowledge gaps. Through systematic examination of productive authors, institutional collaborations, keyword co-occurrences networks, and literature co-citation patterns, this study seeks to delineate the intellectual foundations, emerging hotspots, and frontier trends. These findings may guide evidence-based rehabilitation practices, policy design, interdisciplinary resource integration, and future research prioritization in stroke rehabilitation (21).