Course of Social Participation in the First 2 Years After Stroke and Its Associations With Demographic and Stroke-Related Factors.
Daan P J Verberne, Marcel W M Post, Sebastian Köhler and 3 others
PMID 30178696WHAT IT FOUND
Social participation did not simply improve after stroke.
People increased work and household hours over two years while social and leisure activity decreased, and restrictions eased mostly in the first year. Older, lower-educated, and ADL-dependent patients showed worse courses.
Key findings
01Vocational activity hours rose over two years while social and leisure activity frequency fell.
02Experienced restrictions decreased sharply during the first year and then stabilized.
03Older, lower-educated, and ADL-dependent patients had poorer participation outcomes over time.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study excluded patients living in nursing homes, so results apply only to community-dwelling stroke survivors. The cohort was predominantly ischemic stroke (93%), limiting generalizability to hemorrhagic stroke populations. Premorbid participation levels were based on patient recall, which may lead to overestimation of baseline function. The study was exploratory and did not control for multiple testing. Participation measures did not distinguish between the value patients place on work versus household activities.
Declared interests
The authors declared no potential conflicts of interest. The study was supported by the VSBfonds and coordinated by ZonMw, with additional support from the James S. McDonnell Foundation.
The easy way to misread this
Do not assume that an increase in total participation scores indicates successful social re-engagement. The data showed that while vocational activities increased, social and leisure activities decreased, meaning patients may be trading social connection for work or household duties.