Impact of Environmental Factors on Post-Stroke Disability: An Analytical Cross-Sectional Study

Abstract

Objectives: Identify how environmental barriers and facilitators are associated with disability in stroke survivors.

Materials and methods: An analytical, cross-sectional study was conducted involving individuals in the chronic stage of stroke. The dependent variable was disability, which was assessed using the World Health Organization Disability Assessment Schedule (WHODAS-2.0). Environmental factors (independent variable) were evaluated using the Measure of the Quality of the Environment (MQE). Multiple linear regression analysis was performed to estimate the impact of the environment on disability following a stroke.

Results: Seventy-five individuals (mean age: 54.2 + 9.8 years) were analyzed. The most frequent environmental facilitators were related to technology, social networks, and public services. The main barriers were related to the physical environment. Environmental barrier was a predictor of both overall disability [F(1.73) = 4.24; R²=0.06; β = -0.23; t = -2.06; p=0.04] and participation [F(1.73) = 10.45; R²=0.13; β = -0.35; t = -3.23; p = 0.01]. Environmental facilitators were not correlated with disability.

Conclusion: Environmental barriers explained 13% of the variation in restrictions to social participation and were also a significant predictor of overall disability. The main barriers were related to the physical environment. Identifying environmental factors related to disability in stroke victims can assist in the planning of guided therapy.

Keywords: Disability; Disability and Health; Environment; International Classification of Functioning; Stroke.