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Behavioural Neurology
Volume 2018, Article ID 5472018, 22 pages
Review Article

Scoping Review: The Trajectory of Recovery of Participation Outcomes following Stroke

1Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
2Occupational Therapy, Department of Community and Clinical Allied Health, School of Allied Health, La Trobe University, Melbourne, VIC, Australia
3Neurorehabilitation and Recovery, Stroke Division, The Florey Institute of Neuroscience and Mental Health, Heidelberg, VIC, Australia
4Occupational Therapy Department, St Vincent’s Hospital Melbourne, Fitzroy, VIC, Australia
5Program in Occupational Therapy, Washington University School of Medicine, St Louis, MO, USA

Correspondence should be addressed to Batya Engel-Yeger;

Received 6 April 2018; Revised 29 June 2018; Accepted 26 July 2018; Published 9 September 2018

Academic Editor: Norbert Kovács

Copyright © 2018 Batya Engel-Yeger et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Participation is a central concept in health and well-being and healthcare, yet operationalizing this concept has been difficult. Its definition, uses in healthcare, and impacts on recovery require ongoing research. Our review question goes like this: from the longitudinal evidence investigating participation among stroke survivors, what are the patterns of participation recovery in stroke survivors over time, and what interventions are used to improve participation? To fully understand these questions, we also ask, how is participation defined in the stroke literature, and what are the measures of participation used in the stroke literature? A systematic scoping review was undertaken using the search terms “stroke,” “longitudinal,” “participation,” and “outcome” in seven databases. Articles included were published until April 2017, written in English, and had at least two longitudinal assessments of participation. Fifty-nine articles met the inclusion criteria. The International Classification of Functioning, Disability and Health was the most frequent definition of participation used (34%). There were 22 different measures of participation. Eight of ten studies demonstrated significant improvements in participation up to 12 months poststroke. Efficacy of interventions and their impact on participation varied. The various definitions, measures, and intervention efficacies of participation highlight the need for further research worldwide into achieving meaningful participation and quality of life among stroke survivors. Future practice should include participation as a main outcome measure.