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Joseph C1,2, Conradsson D2, Rhoda A1
1University of the Western Cape, Faculty of Community and Health Sciences, Cape Town, South Africa, 2Karolinska Institutet, Stockholm, Sweden
Background: Participation, i.e. the involvement in life situations, including age and culture appropriate roles and activities, is of one the most important goals after stroke. The complexity of stroke impairments, coupled with the influence of contextual factors, almost always result in participation restrictions.
Purpose: To determine factors, as derived from the domains of the ICF, that influence participation among community-dwelling persons living with stroke in South Africa.
Methods: Forty-nine conveniently selected persons with chronic stroke were included in this cross-sectional study evaluating functioning outcomes. The main dependent outcome, participation, was measured using the Subjective Index of Physical and Social Outcome (SIPSO) scale. This ordinal scale ranges from 0-40 with higher scores indicating greater participation. Independent factors related to socio-demographic and environmental variables, as well as stroke severity, balance performance, self-efficacy, activities (as measured with the Barthel Index and gait velocity) and physical activity volume. Multiple regression analysis was carried out to determine independently associated factors influencing participation.
Results: Of the 49 initially included, 42 presented with completed data. The mean age of this cohort was 58 years, with a mean time since stroke of 30 months. The mean (SD) SIPSO participation score was 24.92 (9.97). Independent factors related to the total score of SIPSO were age (β=0.14; p=0.041), balance performance (β=0.38; p=0.006), and falls self-efficacy (β= -0.44; p 0.001). This model explains 76% of the variance in the total SIPSO score.
Conclusion(s): The data suggest that participation is influenced by diverse factors, including age, balance impairments and self-efficacy.
Implications: Apart from age, the remaining factors could be addressed via comprehensive rehabilitation programs. These programs should address underlying impairments and incorporate self-management principles.
Keywords: Stroke, Participation, South Africa
Funding acknowledgements: The National Research Foundation of South Africa.
Purpose: To determine factors, as derived from the domains of the ICF, that influence participation among community-dwelling persons living with stroke in South Africa.
Methods: Forty-nine conveniently selected persons with chronic stroke were included in this cross-sectional study evaluating functioning outcomes. The main dependent outcome, participation, was measured using the Subjective Index of Physical and Social Outcome (SIPSO) scale. This ordinal scale ranges from 0-40 with higher scores indicating greater participation. Independent factors related to socio-demographic and environmental variables, as well as stroke severity, balance performance, self-efficacy, activities (as measured with the Barthel Index and gait velocity) and physical activity volume. Multiple regression analysis was carried out to determine independently associated factors influencing participation.
Results: Of the 49 initially included, 42 presented with completed data. The mean age of this cohort was 58 years, with a mean time since stroke of 30 months. The mean (SD) SIPSO participation score was 24.92 (9.97). Independent factors related to the total score of SIPSO were age (β=0.14; p=0.041), balance performance (β=0.38; p=0.006), and falls self-efficacy (β= -0.44; p 0.001). This model explains 76% of the variance in the total SIPSO score.
Conclusion(s): The data suggest that participation is influenced by diverse factors, including age, balance impairments and self-efficacy.
Implications: Apart from age, the remaining factors could be addressed via comprehensive rehabilitation programs. These programs should address underlying impairments and incorporate self-management principles.
Keywords: Stroke, Participation, South Africa
Funding acknowledgements: The National Research Foundation of South Africa.
Topic: Disability & rehabilitation; Neurology: stroke; Outcome measurement
Ethics approval required: Yes
Institution: University of the Western Cape
Ethics committee: Senate Research Grants and Study Leave Committee
Ethics number: Number 15/6/82
All authors, affiliations and abstracts have been published as submitted.
