Lingraphica Co-founder and Chief Scientist, Dr. Richard Steele, summarizes the results of research from rehabilitation specialists from the MGH Institute of Health Professions (Boston, MA) and Washington University (St. Louis, MO) who have published research on stroke survivors — including persons with aphasia (PWA) as well as persons without aphasia (Pw/oA) — to identify factors that significantly affect post-stroke social participation.

The investigators focused on three factors in particular — severity of stroke, impact on perceived mobility, and post-stroke environmental factors — to determine their effects on social participation in members of both groups.

There were 48 participants — 22 PWA and 26 Pw/oA — all of whom were at least six months post-onset. The National Institutes of Health (NIH) Stroke Scale was used to determine participants’ stroke severity; the Stroke Impact Scale’s mobility domain was used to determine stroke’s effects on subjects’ perceived mobility; MOS Social Support–Positive Social Interactions Scale characterized support and Measure of Stroke Environment characterized environmental factors; and Activity Card Sort results were used to establish subjects’ social participation. A correlational, cross-sectional analysis examined relationships among the assessed domains to identify significant similarities and contrasts within and between groups.

Results show that both PWA and Pw/oA experience large declines (25-30%) in social participation post-stroke; in comparing these groups, however, no significant difference was found. Perceived mobility was not independently found to predict participation in social activities, nor was severity of neurological impairment or built environment found to be significantly correlated with social participation. Higher assessed levels of social support, on the other hand, did emerge as independent and significant contributors to greater social participation.

This study corroborates that stroke has broadly detrimental effects on social participation, the negative effects being of comparable magnitude regardless of presence or absence of aphasia. Providing appropriate social support is identified as a crucial factor in ameliorating declines in social participation. The other factors assessed in this study, such as neurological impairment, mobility impacts, and built environment, were not found to be significant correlates of social participation. For rehabilitation professionals, these findings underscore the importance of educating stroke survivors and caregivers on the importance of social support mechanisms, and of assuring introduction, training, and assistance in their sustained, effective use.

For further reading: E.L. Foley, M.L. Nicholas, C.M. Baum, & L.T. Connor, 2019. Influence of Environmental Factors on Social Participation Post-StokeBehavioral Neurology, vol. 2019, ID #2606039.

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