Journal of the Korean Society of Physical Medicine (대한물리의학회지)

The Korean Society of Physical Medicine (대한물리의학회)
권호 표지
DOI QR코드

DOI QR Code

Participation and Activities of Daily Living, Cognition, And Motor Function According to Residential Area in Stroke Survivors

  • Park, Eun-Young (Department of Secondary Special Education, College of Education, Jeonju University) ;
  • Kim, Won-Ho (Department of Physical Therapy, Ulsan College)
  • Received : 2021.04.13
  • Accepted : 2021.05.11
  • Published : 2021.05.31
Download PDF
⟨ Previous Next ⟩

Abstract

PURPOSE: Social participation is essential for stroke survivors. Although participation restrictions are affected by several factors, a few studies have focused on the effects of living in a particular residential area (urban versus rural) on the participation restrictions after a stroke. This study examined the factors affecting participation restrictions in stroke survivors according to the residential area. METHODS: One hundred sixty-six stroke patients (including 130 living in urban areas and 36 living in rural areas) were recruited for this study. The Korean Modified Barthel Index (K-MBI) was used to assess the activities of daily living (ADL). The Korean Mini-Mental Examination Status (MMSE-K) was used to assess cognition. The motor function was evaluated using the Fugl-Meyer function assessment (FMA). Path analysis was used to test the hypothesized model of participation restriction. RESULTS: The proposed path model showed good fit indices. In rural and urban areas, the direct effects were significant between the ADL and participation restrictions (β = -.673 and -.457, respectively). For urban areas, the direct effects were significant between cognition and participation restrictions (β = -.252). In both area types, motor function and cognition had a significant direct effect on the ADL. CONCLUSION: For urban community-dwelling stroke survivors, the ADL and cognition had direct effects on participation restrictions. For rural area stroke survivors, the ADL had direct effects on participation restrictions. Activity level exercise programs help reduce the participation restrictions. Moreover, it is essential to address cognition training to improve participation in urban community-dwelling stroke survivors.

Keywords

References

  1. Stroke CRCf. Clinical practice guidelines for stroke. Seoul: Clinical Research Center for Stroke. Seoul: Clinical Research Center for Stroke. 2013.
  2. O'Sullivan S. Stroke In: O'Sullivan SB and Schmitz TJ. Physical Rehabilitation FA Davis, Philadelphia, PA. 2007:706-76.
  3. Murray CJ, Lopez AD, Organization WH. The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020. Cambridge: Harvard University Press. 1996.
  4. Fride Y, Adamit T, Maeir A, et al. What are the correlates of cognition and participation to return to work after first ever mild stroke? Top Stroke Rehabil. 2015;22(5):317-25. https://doi.org/10.1179/1074935714Z.0000000013
  5. Eng JJ, Tang P-F. Gait training strategies to optimize walking ability in people with stroke: a synthesis of the evidence. Exp Rev Neurotherap. 2007;7(10):1417-36. https://doi.org/10.1586/14737175.7.10.1417
  6. Bouffioulx E, Arnould C, Thonnard J-L. Satisfaction with activity and participation and its relationships with body functions, activities, or environmental factors in stroke patients. Arch Phys Med Rehabil. 2011;92(9):1404-10. https://doi.org/10.1016/j.apmr.2011.03.031
  7. Robinson CA, Matsuda PN, Ciol MA, et al. Participation in community walking following stroke: the influence of self-perceived environmental barriers. Phys Ther. 2013;93(5):620-27. https://doi.org/10.2522/ptj.20110217
  8. Hammel J, Magasi S, Heinemann A, et al. Environmental barriers and supports to everyday participation: a qualitative insider perspective from people with disabilities. Arch Phys Med Rehabil. 2015;96(4):578-88. https://doi.org/10.1016/j.apmr.2014.12.008
  9. Magasi S, Hammel J, Heinemann A, et al. Participation: a comparative analysis of multiple rehabilitation stakeholders' perspectives. J Rehabil Med. 2009;41(11):936-44. https://doi.org/10.2340/16501977-0450
  10. Mishler E. Validation in inquiry-guided research: The role of exemplars in narrative studies. Harvard Educ Rev. 1990;60(4):415-43. https://doi.org/10.17763/haer.60.4.n4405243p6635752
  11. Heinemann AW, Lai J-S, Magasi S, et al. Measuring participation enfranchisement. Arch Phys Med Rehabil. 2011;92(4):564-71. https://doi.org/10.1016/j.apmr.2010.07.220
  12. Gray DB, Hollingsworth HH, Stark SL, et al. Participation survey/mobility: psychometric properties of a measure of participation for people with mobility impairments and limitations. Arch Phys Med Rehabil. 2006;87(2):189-97. https://doi.org/10.1016/j.apmr.2005.09.014
  13. Organization WH. International classification of functioning, disability and health: ICF. Geneva: World Health Organization. 2001.
  14. Noonan VK, Kopec JA, Noreau L, et al. A review of participation instruments based on the International Classification of Functioning, Disabili and Health. Disabilil Rehabil. 2009;31(23):1883-901. https://doi.org/10.1080/09638280902846947
  15. Hammel J, Jones R, Gossett A, et al. Examining barriers and supports to community living and participation after a stroke from a participatory action research approach. Top Stroke Rehabil. 2006;13(3):43-58. https://doi.org/10.1310/5X2G-V1Y1-TBK7-Q27E
  16. Chau JP, Thompson DR, Twinn S, et al. Determinants of participation restriction among community dwelling stroke survivors: a path analysis. BMC Neurol. 2009; 9(1):49. https://doi.org/10.1186/1471-2377-9-49
  17. Jellema S, van Hees S, Zajec J, et al. What environmental factors influence resumption of valued activities post stroke: a systematic review of qualitative and quantitative findings. Clin Rehabil. 2017;31(7):936-47. https://doi.org/10.1177/0269215516671013
  18. Jackson DL. Sample size and number of parameter estimates in maximum likelihood confirmatory factor analysis: A Monte Carlo investigation. Struct Equat Model. 2001;8(2):205-23. https://doi.org/10.1207/S15328007SEM0802_3
  19. Sanford J, Moreland J, Swanson LR, et al. Reliability of the Fugl-Meyer assessment for testing motor performance in patients following stroke. Phys Ther. 1993;73(7):447-54. https://doi.org/10.1093/ptj/73.7.447
  20. Jung HY, Park BK, Shin HS, et al. Development of the Korean version of Modified Barthel Index (K-MBI): multi-center study for subjects with stroke. J Korean Acad Rehabil Med. 2007;31(3):283-97.
  21. Cardol M, de Haan RJ, van den Bos GA, et al. The development of a handicap assessment questionnaire: the Impact on Participation and Autonomy (IPA). Clin Rehabil. 1999;13(5):411-19. https://doi.org/10.1191/026921599668601325
  22. Olobatuyi ME. A user's guide to path analysis. University Press of America. 2006.
  23. Bentler PM. Comparative fit indexes in structural models. Psych Bull. 1990;107(2):238. https://doi.org/10.1037/0033-2909.107.2.238
  24. Jobson J. Multiple linear regression: Applied multivariate data analysis. Springer. 1991.
  25. Manimmanakorn N, Vichiansiri R, Nuntharuksa C, et al. Quality of life after stroke rehabilitation among urban vs. rural patients in Thailand. J Med Assoc Thailand. 2011;91(3):394.
  26. Spitzer J, Tse T, Baum CM, et al. Mild impairment of cognition impacts on activity participation after stroke in a community-dwelling Australian cohort. Occup Particip Health. 2011;31(suppl):S8-15. https://doi.org/10.3928/15394492-20101108-03
  27. Van Der Zee CH, Visser-Meily JM, Lindeman E, et al. Participation in the chronic phase of stroke. Top Stroke Rehabil. 2013;20(1):52-61. https://doi.org/10.1310/tsr2001-52
  28. Choi YI, Park JH, Jung M-Y, et al. Psychosocial predictors of participation restriction poststroke in Korea: A path analysis. Rehabili Psych. 2015;60(3):286. https://doi.org/10.1037/rep0000051
  29. Crowther MR, Scogin F, Johnson Norton M. Treating the aged in rural communities: the application of cognitive- behavioral therapy for depression. J Clin Psych. 2010;66(5):502-12. https://doi.org/10.1002/jclp.20678
  30. Kang H, Park K. Comparison of correlates of depression in late-life between urban and rural areas. J Korean Gerontol Soc. 2012;32(1):129-43.
  31. Zhang L, Yan T, You L, et al. Barriers to activity and participation for stroke survivors in rural China. Arch Phys Med Rehabil. 2015;96(7):1222-28. https://doi.org/10.1016/j.apmr.2015.01.024
  32. French MA, Moore MF, Pohlig R, et al. Self-efficacy mediates the relationship between balance/walking performance, activity, and participation after stroke. Top Stroke Rehabil. 2016;23(2):77-83. https://doi.org/10.1080/10749357.2015.1110306
  33. Cooper CL, Phillips LH, Johnston M, et al. The role of emotion regulation on social participation following stroke. British J Clin Psych. 2015;54(2):181-99. https://doi.org/10.1111/bjc.12068
  34. Warner G, Packer T, Villeneuve M, et al. A systematic review of the effectiveness of stroke self-management programs for improving function and participation outcomes: self-management programs for stroke survivors. Disabil Rehabil. 2015;37(23):2141-63. https://doi.org/10.3109/09638288.2014.996674
  35. Cadilhac DA, Kilkenny MF, Srikanth V, et al. Do cognitive, language, or physical impairments affect participation in a trial of self-management programs for stroke? Intern J Stroke. 2016;11(1):77-84. https://doi.org/10.1177/1747493015607522
  36. Guiney H, Machado L. Benefits of regular aerobic exercise for executive functioning in healthy populations. Psychon Bul Rev. 2013;20(1):73-86. https://doi.org/10.3758/s13423-012-0345-4
  37. Ayerbe L, Ayis S, Wolfe CD, et al. Natural history, predictors and outcomes of depression after stroke: systematic review and meta-analysis. British J Psych. 2013;202(1):14-21. https://doi.org/10.1192/bjp.bp.111.107664
  38. Walker C, Sunderland A, Sharma J, et al. The impact of cognitive impairment on upper body dressing difficulties after stroke: a video analysis of patterns of recovery. J Neurol Neurosurg Psych. 2004;75(1):43-8.
  39. Pallesen H. Body, coping and self-identity. A qualitative 5-year follow-up study of stroke. Disabil Rehabil. 2014;36(3):232-41. https://doi.org/10.3109/09638288.2013.788217