Mohammad Abu Shaphe, Mohammed M Alshehri, Ramzi A Alajam, Ahmed Ghazwani, Ahmad Sahely, Alanoud Huraysi, Basema Temehy, Aafreen, Ashfaque Khan, G Shankar Ganesh, Abdur Raheem Khan
Community participation was independently associated with return-to-work outcomes following stroke and may represent an important determinant of long-term societal reintegration. These findings support rehabilitation approaches that extend beyond impairment reduction and emphasise participation, community reintegration, and vocational recovery as key components of long-term stroke rehabilitation.
BACKGROUND/OBJECTIVE: Return to work is an important indicator of successful recovery following stroke; however, vocational reintegration may be influenced by factors extending beyond physical function and disability. Evidence regarding the relationships among community participation, quality of life, functioning, and return-to-work (RTW) outcomes remains limited in Saudi Arabia. The study investigated RTW outcomes, community participation, quality of life, and functional outcomes among stroke survivors 1 year after rehabilitation and examined the associations between community participation and RTW outcomes among stroke survivors.
METHODS: A retrospective cohort study was conducted among 150 stroke survivors who completed rehabilitation at a university-affiliated rehabilitation service in Jazan, Saudi Arabia. RTW status at 12 months was recorded as the primary outcome. Community participation, quality of life, disability, cognition, functional independence, activities of daily living, and ICF-based functioning were assessed using validated outcome measures. Correlation analyses and hierarchical regression models were used to examine associations among study variables.
RESULTS: Eighty-five participants (56.6%) returned to paid employment within 12 months of rehabilitation. RTW status was significantly associated with functional independence, community participation, quality of life, cognitive function, and activities of daily living (all p < 0.05). Community participation remained independently associated with RTW status after adjustment for demographic and clinical characteristics after adjustment for demographic and clinical characteristics. Participation restrictions persisted despite relatively favourable functional outcomes, indicating a gap between functional recovery and societal reintegration.
CONCLUSION: Community participation was independently associated with return-to-work outcomes following stroke and may represent an important determinant of long-term societal reintegration. These findings support rehabilitation approaches that extend beyond impairment reduction and emphasise participation, community reintegration, and vocational recovery as key components of long-term stroke rehabilitation.