title: Level and predictors of participation in patients with stroke undergoing inpatient rehabilitation.
abstract: BACKGROUND
  The level of participation is an important factor influencing rehabilitation outcome. However, few studies have evaluated rehabilitation participation and its clinical predictors in patients with stroke. This study aimed to establish the level of participation in patients with stroke undergoing inpatient rehabilitation, and define the clinical predictors for participation.
  
  
  METHODS
  This was a prospective observational study of first-time patients with stroke admitted to a rehabilitation centre over a 12-month period. The primary outcome measure was the level of rehabilitation participation as measured on the Pittsburgh Rehabilitation Participation Scale (PRPS). PRPS measurements were made one week after admission and one week before planned discharge from inpatient rehabilitation. Other outcome measures evaluated were the National Institute of Health Stroke Scale, Functional Independence Measure (FIM), Elderly Cognitive Assessment Questionnaire (ECAQ), Centre for Epidemiologic Studies-Depression Scale, Fatigue Severity Scale (FSS), Lubben Social Network Scale-Revised, and Multidimensional Health Questionnaire.
  
  
  RESULTS
  A total of 122 patients with stroke were studied. The mean PRPS score on admission was relatively high at 4.30 ± 0.90, and this improved to 4.65 ± 0.79 before planned discharge (p < 0.001). On multivariate analysis, the mean PRPS score on admission was predicted by FIM, EACQ and FSS scores on admission, but not by variables such as age, gender, depression, social support, or health attitudes and beliefs.
  
  
  CONCLUSIONS
  Patients with lower levels of participation were more likely to be functionally dependent, cognitively impaired and have more fatigue. We suggest that in addition to cognition, fatigue should be routinely screened in patients with stroke undergoing rehabilitation.
authors.affiliation: Department of Rehabilitation Medicine, Tan Tock Seng Hospital, c/o Ang Mo Kio Hospital, 17 Ang Mo Kio Ave 9, Singapore 569766. keng_he_kong@ttsh.com.sg.
authors.forename: Su-Yin
authors.initials: SY
authors.lastname: Yang
authors.forename: Keng He
authors.initials: KH
authors.lastname: Kong
mesh_terms: D003071:Cognition / Q000502:physiology; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007297:Inpatients; D007902:Length of Stay / Q000639:trends; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods*; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011446:Prospective Studies; D020127:Recovery of Function / Q000502:physiology; D012047:Rehabilitation Centers / Q000706:statistics & numerical data*; D012846:Singapore / Q000453:epidemiology; D020521:Stroke / Q000453:epidemiology / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome