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.
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