Social Support Mediates the Association Between Abilities and Participation After Stroke

OTJR (Thorofare N J). 2024 May 12:15394492241249446. doi: 10.1177/15394492241249446. Online ahead of print.

Abstract

Stroke survivors face participation restrictions, yet little is known regarding how social support affects the association between an individual's abilities and participation. Through a Person-Environment-Occupation-Performance (PEOP) model lens, social support was examined as a potential mediator between ability and participation in cognitively and mobility-demanding activities for stroke survivors with aphasia (persons with aphasia [PWA]) and without aphasia (persons without aphasia [PWOA]). A cross-sectional design, including PWA (n = 50) and PWOA (n = 59) examined associations among person factors (physical impairment, cognition), an environmental factor (social support), and occupational participation through cognitively- and mobility-demanding activity subscales of the Activity Card Sort. Cognition was associated with participation in cognitively demanding activities for both groups, though social support was a mediator only for PWA. Physical impairment was associated with participation in mobility-demanding activities for PWOA, though social support did not mediate that relationship. Social support is key to PWA participating in cognitively demanding activities post-stroke.

Keywords: cognition; participation; stroke.

Plain language summary

Social Support’s Role in Tasks that Require Cognition or Mobility for Stroke Survivors with and without AphasiaAfter a stroke, people can face difficulties doing the things they need and want to do in their daily life. Sometimes a stroke can cause aphasia, a disorder that can make it hard for someone to communicate. Social support occurs when one person helps someone do the things they need and want to do. Certain tasks may require different skills, like cognition (being able to think) or mobility (being able to move). Results showed that cognition is important to do tasks that require a lot of thinking for people who experience a stroke and social support is essential for people with aphasia to do tasks that require a lot of thinking. In addition, mobility is important to do tasks that require walking or movement for people without aphasia.