Topics in Stroke Rehabilitation最新文献

{"title":"Mediation effect of self-efficacy on the relationship between perceived social support and resilience in caregivers of patients with first-stroke in China: a cross-sectional survey.","authors":"Sitong Wang, Qingwen Lu, Dan Zhang, Liqun Wang, Hongxu Jin, Yu Zhou, Ruihang Ma","doi":"10.1080/10749357.2024.2318087","DOIUrl":"10.1080/10749357.2024.2318087","url":null,"abstract":"<p><strong>Background: </strong>Self-efficacy, perceived social support, and resilience in caregivers of first-stroke patients are closely related, while the interaction mechanism remains unclear. This research explores the mediation effect of self-efficacy in the relationship between perceived social support and resilience in caregivers of first-stroke patients in China.</p><p><strong>Methods: </strong>Convenience sampling was designed and used to recruit participants from the General Hospital of Northern Theater in Shenyang, Liaoning Province, China, from February to October 2022, in which 207 self-reported participants completed the Connor-Davidson Resilience Scale (CD-RISC), Multidimensional Scale of Perceived Social Support (MSPSS) and General Self Efficacy Scale (GSES). In addition, the mediation effect of self-efficacy between perceived social support and resilience was determined by the PROCESS macro for SPSS.</p><p><strong>Result: </strong>Among the 207 caregivers of patients with first-stroke, the mean CD-RISC, MSPPS and GSES scores were (72.17 ± 11.28), (71.17 ± 8.99), and (29.64 ± 5.03) respectively. Caregivers' self-efficacy was positively correlated with perceived social support (<i>r</i> = 0.439, <i>p</i> < 0.01) and resilience (<i>r</i> = 0.730, <i>p</i> < 0.01). Self-efficacy served a mediation function partially between perceived social support and resilience, whose effect accounted for 52.90% of the total.</p><p><strong>Conclusion: </strong>Both simple and mediation roles of perceived social support and self-efficacy are established in the relationship of resilience among caregivers of first-stroke patients. Positive social support and self-efficacy are two important targets for future interventional studies, and interventions on them may synergistically improve resilience. Hence, the nurses and community workers should correctly evaluate social support and self-efficacy, confirm the health education requirements, and implement counseling intervention to protect and improve the health of first-stroke patients and their families.</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"595-603"},"PeriodicalIF":2.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139906468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Return to work within a year after first stroke: blue and white collar workers comparison, predictors and causal mediation assessed during inpatient rehabilitation.","authors":"Alejandro Garcia-Rudolph, Mark Wright, Katryna Cisek, Loreto Garcia, Hector Cusso, Joan Sauri, Eloy Opisso","doi":"10.1080/10749357.2024.2312640","DOIUrl":"10.1080/10749357.2024.2312640","url":null,"abstract":"<p><strong>Background: </strong>Most research focuses around impairments in body function and structure, with relatively only a small number exploring their social impact.</p><p><strong>Objectives: </strong>1) compare characteristics for individuals who before stroke were blue collar vs. white collar workers 2) identify clinical, functional, and job-related factors associated with return to work within 1 year after discharge 3) identify specific ADL individual items (assessed at rehabilitation discharge) as return to work predictors and 4) identify return to work causal mediators.</p><p><strong>Methods: </strong>Retrospective observational cohort study, analyzing adult patients with stroke admitted to rehabilitation between 2007 and 2021, including baseline Barthel Index (BI) and return to work assessments between 2008 and 2022. Kaplan-Meier survival curves and Cox proportional hazards were applied. Causal mediation analyses using 1000-bootstrapped simulations were performed.</p><p><strong>Results: </strong>A total of 802 individuals were included (14.6% returned to work), 53.6% blue-collar and 46.4% white-collar. Blue-collar workers showed significantly higher proportion of ischemic stroke, diabetes, dyslipidemia, and hypertension.Individuals not returning to work presented a higher proportion of blue collar, dominant side affected, aphasia, lower BI scores, and larger length of stay (LOS). Multivariable Cox proportional hazards identified age at injury, aphasia, hypertension, and total discharge BI score (C-Index = 0.74). Univariable Cox models identified three independent BI items at all levels of independence: bathing (C-Index = 0.58), grooming (C-Index = 0.56) and feeding (C-Index = 0.59). BI efficiency (gain/LOS) was a causal mediator.</p><p><strong>Conclusion: </strong>Blue collar workers showed higher proportion of risk factors and comorbidities. Novel factors, predictors, and a return to work mediator were identified.</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"604-614"},"PeriodicalIF":2.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139906469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social participation mediates the relationship between self-efficacy and loneliness among people with stroke during COVID-19: a cross-sectional study.","authors":"SangJin Lee, Samantha B Randolph, Carolyn M Baum, Marjorie L Nicholas, Lisa Tabor Connor","doi":"10.1080/10749357.2024.2312639","DOIUrl":"10.1080/10749357.2024.2312639","url":null,"abstract":"<p><strong>Background: </strong>People post-stroke experience increased loneliness, compared to their healthy peers and loneliness may have increased during COVID due to social distancing. How social distancing affected loneliness among people after stroke is unknown. Bandura's self-efficacy theory suggests that self-efficacy may be a critical component affecting individuals' emotions, behaviors, attitudes, and interpretation of everyday situations. Additionally, previous studies indicate that self-efficacy is associated with both loneliness and social participation. This study investigates relationships among self-efficacy, social participation, and loneliness in people with stroke.</p><p><strong>Objectives: </strong>Determine how social participation affects the relationship between self-efficacy and loneliness in people with stroke during the COVID-19 pandemic.</p><p><strong>Methods: </strong>44 participants were community-dwelling individuals, ≥ 6 months post-stroke who participated in a 2-hour phone interview. A regression-based mediation analysis was conducted using these measures: Participation Strategies Self-Efficacy Scale, Activity Card Sort for social participation, and UCLA Loneliness Scale for loneliness.</p><p><strong>Results: </strong>The total effect of self-efficacy on loneliness was significant (<i>b</i> = -0.36, <i>p</i> = .01). However, social participation fully mediated the relationship between self-efficacy and loneliness (indirect effect, <i>b</i> = -0.11, 95% CI [-0.24, -0.01]; direct effect, <i>b</i> = -0.25, 95% CI [-0.03, 0]).</p><p><strong>Conclusions: </strong>Self-efficacy is associated with both social participation and loneliness in people with stroke in this cross-sectional study. Mediation analysis findings suggest that interventions focused on increasing social participation may prevent or potentially alleviate loneliness in people with stroke who have low self-efficacy.</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"585-594"},"PeriodicalIF":2.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139724136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of hippotherapy simulator exercise program in patients with stroke: a randomized single-blind clinical trial.","authors":"Sergen Öztürk, Onur Aydoğdu, Zübeyir Sari","doi":"10.1080/10749357.2024.2310425","DOIUrl":"10.1080/10749357.2024.2310425","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to investigate the effect of hippotherapy simulator on balance, postural control, mobility, functional capacity and independence level in people with stroke.</p><p><strong>Methods: </strong>This study involved 26 people with stroke aged 18-65, who were randomly assigned to a Hippotherapy Simulator Group (HSG; <i>n</i> = 13) and a Conventional Exercise Group (CEG; <i>n</i> = 13). Patients underwent assessments using the Berg Balance Scale (BBS), Postural Assessment Scale for Stroke (PAS-S), Timed Up and Go Test (TUG), Rivermead Mobility Index (RMI), 2-Minute Walking Test (2-MWT), and Barthel Daily Living Activity Index (BI) to evaluate balance, postural control, mobility, functional capacity, and independence before and after treatment. In the HSG, participants received 30 sessions of conventional exercises and hippotherapy simulator - a mechanical and robotic equipment with a dynamic saddle simulating horse movement - exercises over 6 weeks. Meanwhile, the CEG underwent 30 sessions of conventional exercises alone for 6 weeks.</p><p><strong>Results: </strong>In the post-therapy evaluation between groups, BBS (<i>p</i> = 0.004) and 2-MWT (<i>p</i> < 0.001) scores were higher in HSG compared to CEG. However, no statistically significant difference was found between the two groups in terms of PAS-S, RMI, TUG and BI scores (<i>p</i> > 0.05). Statistically significant differences were found between BBS, PAS-S, RMI, TUG, BI and 2-MWT scores before and after treatment in both groups (<i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>Hippotherapy simulator can be added to conventional exercises to improve balance and functional capacity in people with stroke.</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"576-584"},"PeriodicalIF":2.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139730538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the factors that influence stroke survivors to begin or resume exercise: a qualitative exploration.","authors":"Helena Drummond, Thierry R F Middleton, Anthony I Shepherd, Sally Davenport","doi":"10.1080/10749357.2024.2304970","DOIUrl":"10.1080/10749357.2024.2304970","url":null,"abstract":"<p><strong>Background: </strong>Exercise after stroke has the potential to increase survivors' physical function and decrease disability. However, despite health professional reporting they recommend exercise to stroke survivors, the majority are physically inactive. Stroke survivors have previously expressed a lack of adequate knowledge and skills to engage in exercise.</p><p><strong>Objectives: </strong>The aim of this study was to understand why active stroke survivors chose to (re)engage in exercise and how they went about doing so. A secondary aim was to understand if health professionals had a role in facilitating exercise engagement.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted with stroke survivors who regularly engaged with exercise. Seven people aged between 60 and 71 years participated in the study. Time since stroke varied from 1 to 13 years. A reflexive thematic analysis approach was used to analyze interviews.</p><p><strong>Results: </strong>Exercise was spoken about in a positive light. For some, exercise had always been important, for others it became important after their stroke. The themes of Changing Support Over Time, Old and New Identity and Proactively Impacting the Future were developed. The participants felt that health professionals often facilitated engagement in exercise, although the type of support that was most valued differed at different points in the post-stroke journey.</p><p><strong>Conclusions: </strong>Authoritative support from health professionals and family members helped participants to engage in exercise in the early stages after stroke. Collaboration and being part of a team was appreciated for ongoing exercise engagement. Exercise provided hope as participants developed their identity after stroke.</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"556-563"},"PeriodicalIF":2.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139576538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review of discrete choice experiments in stroke rehabilitation.","authors":"Laura Jolliffe, Lauren J Christie, Nicola Fearn, Michael Nohrenberg, Rasia Liu, Julie F Williams, Mark W Parsons, Alison M Pearce","doi":"10.1080/10749357.2024.2312641","DOIUrl":"10.1080/10749357.2024.2312641","url":null,"abstract":"<p><strong>Objectives: </strong>Existing research qualitatively explores consumer preferences for stroke rehabilitation interventions. However, it remains unclear which intervention characteristics are most important to consumers, and how these preferences may influence uptake and participation. Discrete choice experiments (DCE) provide a unique way to quantitatively measure preferences for health and health care. This study aims to explore how DCEs have been used in stroke rehabilitation and to identify reported consumer preferences for rehabilitation interventions.</p><p><strong>Material and methods: </strong>A systematic review of published stroke rehabilitation DCEs was completed (PROSPERO registration: CRD42021282578). Six databases (including CINAHL, MEDLINE, EconLIT) were searched from January 2000-March 2023. Data extracted included topic area, sample size, aim, attributes, design process, and preference outcomes. Descriptive and thematic analyses were conducted, and two methodological checklists applied to review quality.</p><p><strong>Results: </strong>Of 2,446 studies screened, five were eligible. Studies focused on exercise preference (<i>n</i> = 3), the structure and delivery of community services (<i>n</i> = 1), and self-management programs (<i>n</i> = 1). All had small sample sizes (range 50-146) and were of moderate quality (average score of 77%). Results indicated people have strong preferences for one-to-one therapy (over group-based), light-moderate intensity of exercise, and delivery by qualified therapists (over volunteers).</p><p><strong>Conclusions: </strong>Few DCEs have been conducted in stroke rehabilitation, suggesting consumer preferences could be more rigorously explored. Included studies were narrow in the scope of attributes included, limiting their application to practice and policy. Further research is needed to assess the impact of differing service delivery models on uptake and participation.</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"632-643"},"PeriodicalIF":2.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139900437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differences in rehabilitation evaluation access for rural and socially disadvantaged stroke survivors.","authors":"Corey Morrow, Michelle Woodbury, Annie N Simpson, Eyad Almallouhi, Kit N Simpson","doi":"10.1080/10749357.2024.2312638","DOIUrl":"10.1080/10749357.2024.2312638","url":null,"abstract":"<p><strong>Background: </strong>Most stroke survivors have ongoing deficits and report unmet needs. Despite evidence that rehabilitation improves stroke survivors' function, access to occupational and physical therapy is limited. Describing access to care for disadvantaged communities for different levels of stroke severity will provide proportions used to create Markov economic models to demonstrate the value of rehabilitation.</p><p><strong>Objectives: </strong>The objective of this study was to explore differences in the frequency of rehabilitation evaluations via outpatient therapy and home health for Medicare Part B ischemic stroke survivors in rural and socially disadvantaged locations.</p><p><strong>Methods: </strong>We completed a retrospective, descriptive cohort analysis using the 2018 and 2019 5% Medicare Limited Data Sets (LDS) from the Centers for Medicare and Medicaid Services using STROBE guidelines for observational studies. We extracted rehabilitation Current Procedural Terminology (CPT) codes for those who received occupational or physical therapy to examine differences in therapy evaluations for rural and socially disadvantaged populations.</p><p><strong>Results: </strong>Of the 9,076 stroke survivors in this cohort, 44.2% did not receive any home health or outpatient therapy. Of these, 64.7% had a moderate or severe stroke, indicating an unmet need for therapy. Only 2.0% of stroke survivors received outpatient occupational therapy within the first year Rural and socially disadvantaged communities accessed rehabilitation evaluations at lower rates than general stroke survivors.</p><p><strong>Conclusions: </strong>These findings describe the poor access to home health and outpatient rehabilitation for stroke survivors, particularly in traditionally underserved populations. These results will influence future economic evaluations of interventions aimed at improving access to care.</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"625-631"},"PeriodicalIF":2.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11269038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139900484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validity and intra- and inter-rater reliability of the Tinetti performance-oriented mobility assessment balance subscale using different tele-assessment methods in patients with chronic stroke.","authors":"Birol Önal, Nezire Köse, Şeyma Nur Önal, Hatice Yağmur Zengin","doi":"10.1080/10749357.2024.2307195","DOIUrl":"10.1080/10749357.2024.2307195","url":null,"abstract":"<p><strong>Introduction: </strong>Balance assessments are an important component of rehabilitation. Considering the increasing use of telemedicine to meet rehabilitation needs, it is important to examine the feasibility of such assessments. This study aimed to examine the reliability and validity of the Tinetti Performance-Oriented Mobility Assessment Balance Subscale (POMA-B) when applied via synchronous and asynchronous tele-assessment.</p><p><strong>Methods: </strong>Twenty-five patients with chronic stroke were included in the study. The first physiotherapist assessed the patients on the first day in a face-to-face clinical setting. Synchronous or asynchronous tele-assessment was applied the next day. The assessments were performed in the same time zone, with an interval of one day. The synchronous tele-assessment was done online in real time by the first and second physiotherapists. A reference assessment video was sent to the patients for asynchronous tele-assessment. They were asked to make a video recording while performing the evaluation activities according to the reference video. Then the first and second physiotherapists assessed these video recordings separately. All the tests were repeated 10 days later to determine the intra-rater reliability of the tele-assessment methods.</p><p><strong>Results: </strong>The intra-class correlation coefficients ranged from 0.96 to 0.98 for inter-rater reliability and from 0.97 to 0.98 for intra-rater reliability for both tele-assessment methods. Both asynchronous and asynchronous tele-assessment methods were medium correlated with the face-to-face versions.</p><p><strong>Conclusions: </strong>We demonstrated the validity and reliability of the POMA-B in chronic stroke patients with different tele-assessment methods, typically using the internet and available devices.</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"547-555"},"PeriodicalIF":2.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139547296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraindividual variability in post-stroke cognition and its relationship with activities of daily living and social functioning: an ecological momentary assessment approach.","authors":"Elizabeth G S Munsell, Quoc Bui, Katherine J Kaufman, Stephanie E Tomazin, Bridget A Regan, Eric J Lenze, Jin-Moo Lee, David C Mohr, Mandy W M Fong, Christopher L Metts, Vy Pham, Alex W K Wong","doi":"10.1080/10749357.2024.2307203","DOIUrl":"10.1080/10749357.2024.2307203","url":null,"abstract":"<p><strong>Introduction: </strong>Ecological momentary assessment (EMA) is a methodological approach to studying intraindividual variation over time. This study aimed to use EMA to determine the variability of cognition in individuals with chronic stroke, identify the latent classes of cognitive variability, and examine any differences in daily activities, social functioning, and neuropsychological performance between these latent classes.</p><p><strong>Methods: </strong>Participants (<i>N</i> = 202) with mild-to-moderate stroke and over 3-month post-stroke completed a study protocol, including smartphone-based EMA and two lab visits. Participants responded to five EMA surveys daily for 14 days to assess cognition. They completed patient-reported measures and neuropsychological assessments during lab visits. Using latent class analysis, we derived four indicators to quantify cognitive variability and identified latent classes among participants. We used ANOVA and Chi-square to test differences between these latent classes in daily activities, social functioning, and neuropsychological performance.</p><p><strong>Results: </strong>The latent class analysis converged on a three-class model. The moderate and high variability classes demonstrated significantly greater problems in daily activities and social functioning than the low class. They had significantly higher proportions of participants with problems in daily activities and social functioning than the low class. Neuropsychological performance was not statistically different between the three classes, although a trend approaching statistically significant difference was observed in working memory and executive function domains.</p><p><strong>Discussion: </strong>EMA could capture intraindividual cognitive variability in stroke survivors. It offers a new approach to understanding the impact and mechanism of post-stroke cognitive problems in daily life and identifying individuals benefiting from self-regulation interventions.</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"564-575"},"PeriodicalIF":2.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139567562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of access to rehabilitation professionals by individuals with stroke in the first six months after hospital discharge in Brazil: a study based on the Andersen model.","authors":"Jordana P Magalhães, Iza Faria-Fortini, Kênia Kp Menezes, Isadora A Lara, Ludmilla R Batista, Romeu Sant'anna, Christina Dcm Faria","doi":"10.1080/10749357.2024.2304969","DOIUrl":"10.1080/10749357.2024.2304969","url":null,"abstract":"<p><strong>Background: </strong>determinants of access to rehabilitation professionals after stroke in middle-income countries, where the burden of this disease is higher, are little known.</p><p><strong>Objectives: </strong>To identify the determinants of access to rehabilitation professionals by individuals with stroke at one, three, and six months after hospital discharge in Brazil and compare referral and access rates after discharge.</p><p><strong>Methods: </strong>Longitudinal and prospective study, with individuals with primary stroke, without previous disabilities. At hospital discharge, the number of rehabilitation professionals referred by the multidisciplinary team was recorded. The possible determinants of access, according to Andersen's model, were: a) predisposing factors: age, sex, education levels, and belief that they could improve with treatment; b) need factors: stroke severity, levels of disability; c) enabling factors: socioeconomic status, disposable income for health care, and quality of care provided by rehabilitation professionals. One, three, and six months after hospital discharge, individuals were contacted to identify which rehabilitation professionals were accessed. Multiple linear regression model and Wilcoxon tests were used (α=5%).</p><p><strong>Results: </strong>201 individuals were included. Disability levels and stroke severity explained 31%, 34%, and 39% (p<0.01) of access at one, three, and six months after hospital discharge, respectively. In all periods, there was less access than that recommended at the time of hospital discharge (p<0.01).</p><p><strong>Conclusion: </strong>Need factors (disability levels and stroke severity) were determinants of access in all assessed periods. In addition, in all periods, the comprehensiveness of care for individuals with stroke was compromised.</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"615-624"},"PeriodicalIF":2.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139698396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}