Gunilla Eriksson, M. Carolyn Baum, Timothy J. Wolf, Lisa Tabor Connor; Perceived Participation After Stroke: The Influence of Activity Retention, Reintegration, and Perceived Recovery. Am J Occup Ther 2013;67(6):e131-e138. doi: 10.5014/ajot.2013.008292.
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© 2019 American Occupational Therapy Association
OBJECTIVE. We sought to determine the extent to which perceptions of participation in everyday occupations were affected in a sample of people with predominantly mild stroke. Demographic variables, stroke severity, community integration, participation in everyday occupations, and perceptions of recovery were examined as potential contributors to their perceptions of participation.
METHOD. We conducted a cross-sectional study with 116 people with mild to moderate first stroke assessed approximately 6 mo after stroke.
RESULTS. Perceptions of participation assessed using the Stroke Impact Scale varied (range = 19–100), with a mean score of 82. Regression analyses revealed three factors that contributed to perceptions of participation: retention of previous activities, reintegration in home and community, and perception of stroke recovery.
CONCLUSION. Although the majority of participants reported a high level of perceived participation, more than a third failed to report successful participation.
Nearly two-thirds of the participants in this sample reported a high level of perceived participation. However, more than a third of participants with predominantly mild strokes failed to report perceived successful participation, indicating that rehabilitation intervention is crucial to support reintegration into community and everyday occupations.
Clinicians should not assume that people with mild to moderate stroke will not experience restrictions in participation. Assessment of perceived participation is necessary as a follow-up when people return to the community. This assessment should also include potential contributing factors to perceived participation, such as reported retention of prestroke activities and community reintegration.
Actual doing of wanted and needed activities and a sense of being integrated into the community are essential elements of perceived participation 6 mo after stroke. These components can be targets for clinical intervention to improve participation.
This study points to the need for occupational therapy practitioners to measure and design interventions focused on participation even in people who are able to perform self-care and do not appear to need traditional, medical model–defined rehabilitation services.
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