The impact of physical function on participation in the first year post‐stroke

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Stroke often has a major impact on many aspects of a person's life.1 Due to various disabilities, individuals are restricted when engaging socially or participating in prestroke activities.3 Recovery after stroke generally means improvements in physical, emotional, and cognitive function, as well as the capacity to perform daily activities.6 Having a stroke has shown to have a negative impact on the level of perceived participation over time, even for persons with mild stroke.5
To reflect upon “person‐centered practice,” a person's experience of involvement must be central for participation.11 In this article, the following definition of participation11 is used; participation occurs at the intersection of what a person can do, wants to do, has the opportunity to do, and is not prevented from doing by the world in which the person lives and seeks to participate in. Participation is considered to be an individual experience and should be assessed regarding the individuals perceptions.9 It is thus formed in a social context and influenced by many, partly synergetic factors, which also make participation difficult to measure.3
The Stroke Impact Scale (SIS 3.0)14 is a self‐assessment questionnaire, developed with input from persons with stroke and their proxies to measure the impact of stroke in everyday life. Self‐assessments encourage subjectivity and can lift the role and status of the patients from passive recipients to active participants.15 Engaging the individual in the evaluation process and decision making is widely recognized as an expression of respect for the person's autonomy.15 It is also important that persons with stroke feel that their perceptions are important for the research field.17
Previous stroke researchers have looked into predictors of participation and showed that overall mood, fewer depressive symptoms, physical and cognitive independence, and age could predict the level of participation.3 How self‐assessed functions associate with perceived participation is not well known, and there is a knowledge gap concerning factors that influences the level of experienced participation over time.20 Improved understandings within this area are important to form individualized rehabilitation interventions with appropriate timing.3 The aim of this study was to investigate perceptions of participation and how this related to background characteristics and self‐assessed rehabilitation outcomes, at 1, 6, and 12 months post‐stroke.

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