title: Course of Participation after Subarachnoid Hemorrhage.
abstract: OBJECTIVE
  The study aimed to investigate participation problems in patients with subarachnoid hemorrhage (SAH), and the course of participation between 3 and 12 months post-SAH, and to identify determinants of this course.
  
  
  METHODS
  This is a prospective cohort study.
  
  
  METHODS
  The study was done in the SAH outpatient clinic at the University Medical Center Utrecht.
  
  
  METHODS
  Subjects included patients independent in activities of daily living who visited the SAH outpatient clinic for a routine follow-up visit 3 months after the event.
  
  
  METHODS
  Participation was assessed using the restrictions scale of the Utrecht Scale for Evaluation of Rehabilitation-Participation at 3, 6, and 12 months post-SAH. Repeated measures analysis of variance was conducted to identify possible determinants of participation (demographic and SAH characteristics, mood, and cognition).
  
  
  RESULTS
  One hundred patients were included. Three months after SAH, the most commonly reported restrictions concerned work/unpaid work/education (70.5%), housekeeping (50.0%), and going out (45.2%). Twelve months post-SAH, patients felt most restricted in work/unpaid work/education (24.5%), housekeeping (23.5%), and chores in and around the house (16.3%). Participation scores increased significantly between 3 and 6 months, and between 3 and 12 months, post-SAH. The course of participation was associated with mood, cognition, and gender, but was in the multivariate analysis only determined by mood (F [1, 74] = 18.31, P = .000, partial eta squared: .20), showing lower participation scores at each time point for patients with mood disturbance.
  
  
  CONCLUSIONS
  Participation in functionally independent SAH patients improved over time. However, 1 out of 3 patients (34.9%) still reported one or more participation restrictions 12 months post-SAH. Mood disturbance was negatively associated with the course of participation after SAH.
authors.affiliation: Center of Excellence in Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands; National Military Rehabilitation Center Aardenburg, Doorn, The Netherlands.
authors.forename: Elize M
authors.initials: EM
authors.lastname: Kruisheer
authors.affiliation: Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Irene M C
authors.initials: IMC
authors.lastname: Huenges Wajer
authors.affiliation: Center of Excellence in Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.
authors.forename: Johanna M A
authors.initials: JMA
authors.lastname: Visser-Meily
authors.affiliation: Center of Excellence in Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands; University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands. Electronic address: m.post@dehoogstraat.nl.
authors.forename: Marcel W M
authors.initials: MWM
authors.lastname: Post
mesh_terms: D000046:Academic Medical Centers; D000203:Activities of Daily Living; D000328:Adult; D000339:Affect; D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition; D005260:Female; D006801:Humans; D057187:Independent Living; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009426:Netherlands; D011446:Prospective Studies; D020127:Recovery of Function; D012307:Risk Factors; D012737:Sex Factors; D058992:Social Participation; D000071939:Stroke Rehabilitation; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology* / Q000534:rehabilitation; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Participation; SAH; course; subarachnoid hemorrhage