Abstract

Stroke can lead to impairments that restrict participation in social roles. Despite being recognized as an important outcome in rehabilitation, little is known about the predictors of participation. The aim of this study was to estimate the independent contributions of depressive symptomatology, gender and functional independence and the interaction between gender and depressive symptomatology in predicting participation among stroke survivors 6 months post-stroke beyond those afforded by age, co-morbid conditions and a history of depression. Participants ( n =66) were patients admitted for stroke to a regional hospital, did not have a co-morbid condition which was expected to lead to death and were able to provide consent. Two weeks post-stroke, the following variables were assessed: Depressive symtomatology, as measured by the Stroke-Specific Geriatric Depression Scale; gender; functional independence, as measured by the Barthel Index; age and co-morbid conditions, as measured by a checklist. Three months post-stroke, history of depression was measured by the Structured Clinical Interview for the Diagnosis of DSM-IV Axis I Disorders. Six months post-stroke, participation was measured by the Stroke Impact Scale. Multiple regression analyses generated a significant model ( F (5,60) = 5.74, R 2 =37%, p <0.01), where greater functional independence predicted greater levels of participation. No other study variables were identified as independent predictors. These results are in line with other evidence that functional limitation is a risk factor for restricted participation. Screening and targeting functional independence during hospitalization for stroke will allow for rehabilitation programs to identify those at risk for restricted participation once stroke survivors return to the community.