Factors Associated With Participation in Life Situations for Adults With Stroke: A Systematic Review

Leisle Ezekiel; Johnny Collett; Nancy E Mayo; Lori Pang; Leanne Field; Helen Dawes

doi:10.1016/j.apmr.2018.06.017

Factors Associated With Participation in Life Situations for Adults With Stroke: A Systematic Review

Arch Phys Med Rehabil. 2019 May;100(5):945-955. doi: 10.1016/j.apmr.2018.06.017. Epub 2018 Jul 5.

Authors

Leisle Ezekiel¹, Johnny Collett², Nancy E Mayo³, Lori Pang⁴, Leanne Field², Helen Dawes²

Affiliations

¹ Oxford Institute of Nursing, Midwifery and Allied Health Research (OXINMAHR), Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, United Kingdom. Electronic address: lezekiel@brookes.ac.uk.
² Oxford Institute of Nursing, Midwifery and Allied Health Research (OXINMAHR), Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, United Kingdom.
³ Fellow of the Canadian Academy of Health Sciences, Department of Medicine, School of Physical and Occupational Therapy, McGill University, Montreal, Québec, Canada.
⁴ Central London Community Healthcare NHS Trust, London, United Kingdom.

PMID: 29981316
DOI: 10.1016/j.apmr.2018.06.017

Abstract

Objectives: To identify biopsychosocial factors associated with participation outcomes for adults with stroke and to investigate factors associated with participation at different time points poststroke.

Data sources: Medline, CINAHL, AMED, PyschINFO, and Web of Science were systematically searched using keywords stroke, participation, and outcomes and their synonyms on May 15, 2017.

Study selection: Observational studies reporting on biopsychosocial factors and participation outcomes for community-dwelling adults with stroke were selected. Studies were eligible for inclusion if participation outcomes were measured using indices that mapped to the participation domain of the International Classification of Functioning, Disability and Health (ICF). Intervention studies were excluded. A second reviewer checked all studies against eligibility criteria at each stage.

Data extraction: Data were extracted on any statistically determined association between biopsychosocial factors and participation outcomes.

Data synthesis: The proportion of studies reporting significant associations with variables was classified according to the ICF. The exact binomial test was used to determine the probability that the proportion of studies reporting significant associations was due to chance alone. Qualitative descriptive summaries of each study allowed consideration of interactions between variables and changes in participation over time points.

Conclusions: Although depressive symptoms, cognitive functioning, and mobility were found to have the strongest associations with participation, we found that other frequently occurring factors (such as fatigue and environmental factors) were less extensively considered. The diversity of outcome measures encountered within the review highlight the need for a consensus on a core set of outcome measures to evaluate long-term participation in life situations poststroke.

Keywords: Rehabilitation; Social participation; Stroke.

Publication types

Research Support, Non-U.S. Gov't
Systematic Review

MeSH terms

Activities of Daily Living
Age Factors
Cognitive Dysfunction / etiology
Depression / etiology
Fatigue / etiology
Humans
International Classification of Functioning, Disability and Health
Mobility Limitation
Pain / etiology
Severity of Illness Index
Sex Factors
Social Participation*
Stroke / complications
Stroke / physiopathology*
Stroke / psychology*
Time Factors