Does the frequency of participation change after stroke and is this change associated with the subjective experience of participation?

A.M.V. Blomer, M.L. van Mierlo, J.M. Visser-Meily, C.M. van Heugten, M.W. Post*

*Corresponding author for this work

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OBJECTIVE: To investigate changes in the frequency of participation six months post stroke compared to the prestroke situation and establish whether such a change is associated with participation restrictions and satisfaction with participation six months post stroke. DESIGN: Inception cohort study. Prestroke frequency of participation was measured retrospectively in the first week post stroke. Frequency, participation restrictions and satisfaction with participation were assessed six months post stroke. SETTING: General hospitals and home residences in the Netherlands PARTICIPANTS: Patients with stroke (N = 325; 65.5% male; mean age 66.9 (SD 12.2) years) admitted to one of six participating general hospitals. INTERVENTION: Not applicable. MAIN OUTCOME MEASURE: Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-Participation) [0-100], consisting of three scales: frequency, restrictions and satisfaction. The frequency scale consists of two parts: vocational activities (work, volunteer work, education and household activities) and leisure and social activities. RESULTS: Vocational activities showed a large decrease (effect size: 0.6) and leisure and social activities a small decrease (effect size: 0.13) post stroke. In multiple regression analyses, both the frequency of participation in vocational activities six months post stroke and the decrease in vocational activities compared to before the stroke were significantly associated with the participation restrictions experienced and satisfaction with participation after controlling for age, gender, level of education, dependency in activities of daily living, cognitive functioning, and presence of depressive symptoms. The presence of depressive symptoms showed the strongest association with the subjective experience of participation. CONCLUSIONS: The frequency of participation decreased after a stroke and this decrease was associated with the participation restrictions experienced and satisfaction with participation. Resuming vocational activities and screening and, if applicable, treatment of depressive symptoms should be priorities in stroke rehabilitation.
Original languageEnglish
Pages (from-to)456-463
Number of pages8
JournalArchives of Physical Medicine and Rehabilitation
Issue number3
Publication statusPublished - Mar 2015


  • Rehabilitation
  • Social participation
  • Stroke

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