Social participation after community stroke rehabilitation: individual and intervention factors in a retrospective cohort study
In brief
Only 17% improved social participation after community stroke rehabilitation
In this retrospective cohort of 534 patients, 17% had a meaningful increase in social participation after home-based community stroke rehabilitation. Improvement was associated with programs addressing mobility, adapted physical activity, communication, and return to work, but the observational design cannot show these interventions caused the gains; which components work best remains unclear.
- Journal
- Annals of physical and rehabilitation medicine (Q1)
- Published
- 31 October 2026
- Study design
- Prospective / inception cohort
- Evidence level
- Level 2, Moderate (CEBM 2b)
- Authors
- Alix Poyet, Soléane Vielotte, Lisa Dalmon, Stéphane Mandigout, David Bernikier, Jean-Yves Salle, et al.
- PMID
- 42966329
- DOI
- 10.1016/j.rehab.2026.102183
Why clinicians should know about it
- Picked for Rehabilitation (paper of the day, 3 November 2026): Community stroke rehabilitation outcomes target social participation
Abstract
BACKGROUND: Improving social participation is a key objective of poststroke rehabilitation, yet determinants of successful outcomes in Community Stroke Rehabilitation Teams (CSRT) remain poorly understood. In particular, the respective contributions of person-related and intervention-related factors need clarification. OBJECTIVE: To identify person-related and intervention-related factors associated with improvement in social participation following a home-based CSRT rehabilitation program. METHODS: We conducted a retrospective cohort study including 534 patients with stroke managed by a CSRT between 2019 and 2024. Social participation was assessed using the Frenchay Activities Index (FAI) at baseline and after intervention. Responders were defined as a FAI score increase ≥7 points. Multivariable logistic regression analyses were performed to identify independent predictors among patient characteristics and intervention components. RESULTS: Seventeen percent of participants achieved an improvement in FAI ≥7 points. Independent person-related factors included younger age (OR 0.975; P = 0.010) and higher baseline functional status (Barthel Index) (OR 1.027; P = 0.005). Regarding intervention-related factors, programs including adapted physical activity (OR 2.01; P = 0.023), mobility-focused interventions (OR 3.21; P = 0.043), communication (OR 2.15; P = 0.035), and work reintegration support (OR 2.17; P = 0.015) were significantly associated with FAI improvement. Participation in therapeutic education workshops was more frequent among Responders (88%vs 60%, P < 0.001), particularly those focused on adapted physical activity, mobility retraining, and communication. Responders also showed greater improvement in quality of life. CONCLUSION: Personal and stroke-related factors show limited ability to predict improvement in social participation. In contrast, key interventions targeting mobility, physical activity, communication, and work reintegration are significantly associated with an improvement in social participation. DATA REGISTRATION: This study was a retrospective observational study based on routine clinical care and was not prospectively registered in an international trial registry.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.