Complexity of Participation Post-Stroke: Longitudinal Assessment of Community Participation, Positive Affect, Social Support and Functional Independence

OBJECTIVE: To investigate longitudinal, predictive associations between community participation, positive affect, social support, and functional independence for individuals post-stroke at 3 and 12 months post-discharge. DESIGN: Longitudinal design. SUBJECTS: Data from 544 participants were obtained from the Stroke Recovery in Underserved Populations (2005-06) database. METHODS: A cross-lagged panel network analysis to identify the complex set of predictive relationships between community participation, positive affect, social support, and functional independence 3 months post-discharge to 12 months post-discharge. RESULTS: Community participation, particularly religious/spiritual activities, was an early predictor of later motor (functional) independence and social support. In addition, positive affect was an early predictor of social support. CONCLUSION: While participation in social situations is a desired outcome post-stroke, the results of this study indicate the importance of identifying early factors that influence community participation throughout the recovery process.