title: Participation in the chronic phase of stroke.
abstract: BACKGROUND
  Participation is a multidimensional concept, consisting of an objective and a subjective dimension. Many studies have focused on determinants of only 1 dimension of participation post stroke.
  
  
  OBJECTIVE
  To describe participation (both objective and subjective) and to determine how physical and cognitive independence and subjective complaints (pain, fatigue, and mood) influence participation in community-dwelling stroke survivors in the Netherlands.
  
  
  METHODS
  The Utrecht Scale for Evaluation of Rehabilitation (USER) measures physical and cognitive independence and subjective complaints. USER-Participation measures 3 dimensions of participation: frequency (objective perspective), restrictions (subjective perspective), and satisfaction (subjective perspective). Spearman correlations and backward linear regression analyses were used to analyze associations between the 3 USER-Participation scores with demographics, stroke characteristics, physical and cognitive independence, and subjective complaints.
  
  
  RESULTS
  Of the 111 participants, 48.5% returned to work post stroke, but mostly for only 1 to 16 hours a week. Experienced participation restrictions were most prevalent in physical exercise, chores in/around the house, housekeeping, and outdoor activities. On average, participants were relatively satisfied with their participation, but dissatisfaction occurred in cognition, activities outdoors, and work/housekeeping. Regression analysis revealed that objective participation was determined by physical and cognitive independence, age, and education, whereas subjective participation was determined by physical and cognitive independence, fatigue, and mood.
  
  
  CONCLUSIONS
  Most participants experienced participation problems, despite relatively good physical recovery. In addition to physical and cognitive factors, subjective complaints of persons with stroke should be addressed in the rehabilitation program.
authors: University Medical Center, Utrecht, Utrecht, the Netherlands.
authors: Carlijn H
authors: CH
authors: van der Zee
authors: Johanna M A
authors: JM
authors: Visser-Meily
authors: Eline
authors: E
authors: Lindeman
authors: L
authors: L
authors: Jaap Kappelle
authors: Marcel W M
authors: MW
authors: Post
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D002908:Chronic Disease; D003072:Cognition Disorders / Q000209:etiology; D004185:Disability Evaluation; D005221:Fatigue / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D019964:Mood Disorders / Q000209:etiology; D009043:Motor Activity; D009426:Netherlands / Q000453:epidemiology; D010358:Patient Participation; D010549:Personal Satisfaction; D012111:Residence Characteristics; D057566:Self Report; D020521:Stroke / Q000150:complications / Q000453:epidemiology / Q000523:psychology*; D000071939:Stroke Rehabilitation; D017741:Survivors