1. Factors associated with participation
in life situations for community stroke survivors: a systematic review.
Leisle Ezekiel
Lecturer and Phd student.

2. Introduction Rationale Key concepts Aims Methods Results Analysis
Discussion.

3. Why participation in life situations?
Evidence that stroke survivors experience long- term participation restrictions with detrimental effects on their quality of life (Skolarus et al 2014)
Lack of focus on long term support and community participation (Obembe& Eng 2016)
Changing demographics - increase in younger people experiencing stroke and increased survival rate.
Participation is the intersection between the person and the environment - modifiable (Whiteneck et al 2006)

4. Key concepts: International classification of functioning, disability and health (WHO 2002)

5. Methods: research questions and protocol.
Available at

6. Methods: eligibility for inclusion
Included:
Community dwelling stroke survivors (all strokes) aged 18 and over.
Studies with mixed populations were included if 90% of participants had stroke.
Observational studies
Investigated biopsychosocial factors associated with participation outcomes
Written in English.
Excluded intervention studies.

8. Risk of bias.

9. Data extraction.

10. Results

12. Results: longitudinal studies.

13. Discussion
Participation restrictions continued in the longer term but stabilised six months to one-year post stroke.
Contextual factors such as older age, stroke severity, comorbidities associated with worse participation outcomes.
Stroke related impairments associated with poor participation were cognitive, aphasia, depressive symptoms
Activity limitations (mobility and activities of daily living).

14. Potentially modifiable factors
Social support emerged as a positive factor.
Insufficient evidence to comment on interactions between environment, person and the impact on participation
Evidence of a reciprocal relationship between depression and poor participation (White et al 2014, Zhang et al 2015).

15. Questions Thank you for listening lezekiel@brookes.ac.uk

16. References
Obembe, A., O. and Eng, J., J. (2016) 'Rehabilitation Interventions for Improving Social Participation after Stroke: a Systematic Review and Meta-analysis', Neurorehabilitation and Neural Repair, 30(4), pp doi: /
Skolarus, LE, Burke, JF, Brown DL, Freedman, VA (2014) Understanding stroke survivorship: expanding the concept of poststroke disability. Stroke 45 (1) , pp
Whiteneck, G. (2006) 'Conceptual Models of Disability:Past, Present, and Future', in Field, M., Jette, A. & Martin, L. (eds.) Workshop on Disability in America: A New Look. Summary and Background Papers. Washington DC: National Academies Press, pp
WHO (2002) 'Towards a Common Language for Functioning, Disability and Health: ICF.'. Geneva: World Health Organisation. Available at: (Accessed: 25/08/2015).

17. References
White, J. H., Attia, J., Sturm, J., Carter, G. and Magin, P. (2014) 'Predictors of depression and anxiety in community dwelling stroke survivors: a cohort study', Disabil Rehabil, 36(23), pp doi: /
Zhang, L., Yan, T., You, L. and Li, K. (2015) 'Barriers to Activity and Participation for Stroke Survivors in Rural China', Archives of Physical Medicine & Rehabilitation, 96(7), pp p. doi: /j.apmr