Scoping Review: The Trajectory of Recovery of Participation Outcomes following Stroke

Abstract

Participation is a central concept in health and well-being and healthcare, yet operationalizing this concept has been difficult. Its definition, uses in healthcare, and impacts on recovery require ongoing research. Our review question goes like this: from the longitudinal evidence investigating participation among stroke survivors, what are the patterns of participation recovery in stroke survivors over time, and what interventions are used to improve participation? To fully understand these questions, we also ask, how is participation defined in the stroke literature, and what are the measures of participation used in the stroke literature? A systematic scoping review was undertaken using the search terms “stroke,” “longitudinal,” “participation,” and “outcome” in seven databases. Articles included were published until April 2017, written in English, and had at least two longitudinal assessments of participation. Fifty-nine articles met the inclusion criteria. The International Classification of Functioning, Disability and Health was the most frequent definition of participation used (34%). There were 22 different measures of participation. Eight of ten studies demonstrated significant improvements in participation up to 12 months poststroke. Efficacy of interventions and their impact on participation varied. The various definitions, measures, and intervention efficacies of participation highlight the need for further research worldwide into achieving meaningful participation and quality of life among stroke survivors. Future practice should include participation as a main outcome measure.

Fatigue, Participation and Quality of Life in Adolescents and Young Adults with Acquired Brain Injury in an Outpatient Rehabilitation Cohort

“…15,51,52 Participation Patients and their parents in this study reported participation restrictions in all domains of participation (median total score 82.5 (IQR 68.8, 92.3), 91.1 (80.0, 96.9), respectively), supporting earlier studies in this patient population (pediatric ABI 27,53 ; adult mTBI 54 ; stroke. 55 ) In the current study, AYAs reported significantly more participation restrictions than their parents, in home, community and school activities. Previous research on patientand parent-reported participation with the CASP has found patients reporting less participation restrictions than their parents.…”

Participation in Younger and Older Adults Post-stroke: Frequency, Importance, and Desirability of Engagement in Activities

“…The SIS-P is the most frequently used scale to measure participation following stroke (15). The SIS-P is a self-report questionnaire containing 8 questions that ask the participant to rate how much of the time he or she has been limited in the past 4 weeks in work, social, productive activities and control over one's life (16).…”

Activity Performance, Participation, and Quality of Life Among Adults in the Chronic Stage After Acquired Brain Injury—The Feasibility of an Occupation-Based Telerehabilitation Intervention

“…However, most studies currently continue to emphasize measurement and intervention in terms of motor function and mobility. Therefore, further research focusing on achieving meaningful participation and improving QoL, extending beyond impairment remediation approaches, is still needed (10, 17).…”