Long-term restrictions in participation in stroke survivors under and over 70 years of age

Abstract

Purpose: This study aims to (1) assess differences in participation restrictions between stroke survivors aged under and over 70 years and (2) identify predictors associated with favorable and unfavorable longterm participation in both age groups. Methods: Prospective cohort study in which 326 patients were assessed at stroke onset, two months and one year after stroke. The Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-Participation) was used to measure participation restrictions one year after stroke. Bivariate and multivariate logistic regression analyses were performed including demographic factors, stroke-related factors, emotional functioning and comorbidity as possible predictors. Results: Stroke survivors aged over 70 years perceived more participation restrictions in comparison to stroke survivors aged under 70 years one year after stroke. Independently significant predictors for unfavorable participation outcomes were advancing age, more severe stroke and anxiety symptoms in patients aged over 70 years, and female gender, more severe stroke, impaired cognition and depression symptoms in patients aged under 70 years. Lower age was the only independent predictor associated with favorable participation after one year in stroke survivors aged over 70 years. Conclusions: This study emphasizes the need to pay more attention to participation restrictions in elderly stroke survivors. ä IMPLICATIONS FOR REHABILITATIONMore attention in the rehabilitation process should be paid to restrictions in participation of stroke survivors aged older than 70 years, taking into account the different participation needs and predictors of older stroke survivors. Early screening on the presence of anxiety symptoms could potentially prevent long-term restrictions in participation in stroke survivors aged over 70-year old. Stroke survivors experience considerable restrictions in physical activity and mobility after one year, highlighting the need for the development of community-based exercise programs for stroke survivors.ARTICLE HISTORY

Social participation of adult patients with spinal muscular atrophy: Frequency, restrictions, satisfaction, and correlates

“…Our data, therefore, seem to be in line with previous reports on participation in work activities of patients with moderate to severe motor impairments. The satisfaction scores for patients with SMA were also similar to those previously reported by patients with spinal cord injury and patients after stroke . This reflects the fact that patients in different situations are able to reorganize their social activities, on average, in a satisfactory way, regardless of their restrictions and type of condition.…”

“…Participation was measured using the Utrecht Scale for Evaluation Rehabilitation–Participation (USER‐P), a self‐report instrument with 32 items. Validity and reproducibility of the USER‐P scale are good . Sum scores are calculated for the Frequency, Restrictions, and Satisfaction scales, and each sum score is converted to a score on a scale ranging from 0 to 100.…”

“…Validity and reproducibility of the USER-P scale are good. [24][25][26][27][28] Sum scores are calculated for the Frequency, Restrictions, and Satisfaction scales, and each sum score is converted to a score on a scale ranging from 0 to 100. Higher scores indicate more favorable levels of participation (higher frequency of activities, fewer restrictions, greater satisfaction).…”

An Intervention to Promote Medication Understanding and Use Self-Efficacy: Design of Video Narratives for Aging Patients at Risk of Recurrent Stroke (Preprint)

“…Most patients' crucial need encompassed of feelings of being independent to lead a quality of life, reducing the severity and prevent recurrent stroke [13][14][15][16]. To be able to achieve these aim, the patient would utmostly require confidence and self-efficacy.…”

“…To be able to achieve these aim, the patient would utmostly require confidence and self-efficacy. Moreover, the initial objectives had to be in line with the MTAC's policy and the recurrent stroke preventative treatment and management guideline of Malaysia's stroke education learning outcomes [14,15].…”