Early Predictors of Long-Term Participation in Stroke Survivors – A Survey of a Rehabilitation Cohort in Nigeria

Abstract

This study sought to identify early predictors of long-term participation among stroke survivors using the International Classification of Functioning, Disability and Health as the conceptual framework. Individuals diagnosed with first-ever stroke were recruited from medical wards of a university teaching hospital in Nigeria. Data on age, gender, pre-stroke employment and marital status, stroke sub-type, laterality and severity (personal factors) were obtained. Motor function (body function) and functional activity (activity) were also assessed within the first month of stroke onset using the short-form Fugl Meyer Scale and the motor sub-scale of the Functional Independence Measure respectively. Participation was assessed at one year with the London Handicap Scale at each stroke survivor’s residence. Multivariable regression analysis was performed to identify significant predictors of participation at an alpha value of 0.05. Fifty-five stroke survivors were assessed with a male majority (60%). Age (β = -0.33; P = < 0.05) emerged as the only significant predictor of participation. The negative beta (β) for age indicated that increasing age predicted poorer participation outcome. With an adjusted R² = 0.40, the regression model explained only 40% of the variance in participation. Age was identified as the sole predictor of participation at one year. This finding has implications for planning and providing participation-enhancing care for elderly stroke survivors while also relevant for setting realistic rehabilitation goals for enhancing long-term post-stroke participation.

Keywords: age; aging; Nigeria; participation; predictors; stroke; stroke survivors