Topics in Stroke Rehabilitation最新文献

{"title":"Effects of ankle-specific perturbation training on lower limb motor function and plantar pressure changes in stroke patients: A randomized controlled study.","authors":"Jianping Li, Haibo Guo, Chao Liu, Shaopeng Zou, Jianwei Xia, Shijia Li, Honghao Zhang, Wei Li, Guqiang Li","doi":"10.1080/10749357.2025.2579910","DOIUrl":"10.1080/10749357.2025.2579910","url":null,"abstract":"<p><strong>Methods: </strong>Between September 2023 and June 2024, 46 stroke patients admitted to the Department of Rehabilitation Medicine at Binzhou Medical University Affiliated Hospital were recruited and randomly assigned to either a control group (<i>n</i> = 23) or an experimental group (<i>n</i> = 23). The control group received conventional rehabilitation training (CRT) with ankle functional training (AFT), whereas the experimental group received APT on top of the control group, 30 minutes per day, 5 times per week, for 4 weeks. Both the control group and the experimental group comprised research subjects selected through screening. The Fugl-Meyer assessment of lower extremity (FMA-LE), Zebris plantar pressure assessment, Noraxon MyoMOTION 3D system, and surface electromyography were used to evaluate the results before and after treatment. The data collected included range of motion (ROM) for the hip and ankle joints, knee flexion angle, maximum pressure value (MPV) in the three-part division of the foot plantar (forefoot, midfoot, rearfoot), and the root mean square (RMS) value of the tibialis anterior (TA) muscle.</p><p><strong>Results: </strong>Compared between groups, the experimental group's FMA, flexion angle of the affected knee, ROM of the affected ankle, MPV of the affected forefoot, and the affected TA muscle RMS values were all significantly better than the control group (<i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>Compared with AFT, APT can effectively improve some kinematic parameters of stroke patients, change the plantar pressure distribution, and optimize the gait pattern of patients when walking. This is of great significance for improving the walking ability of stroke patients.</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"488-501"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145490447","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":"Validity and reliability of the enhanced paper grip test in patients post-stroke.","authors":"Hakan Polat, Fatma Yilmaz, Zekiye Ipek Katirci Kirmaci, Burcu Bağci, Yasemin Ekmekyapar Firat","doi":"10.1080/10749357.2026.2651790","DOIUrl":"10.1080/10749357.2026.2651790","url":null,"abstract":"<p><strong>Background: </strong>Assessing hallux (big toe) pulling force after stroke is important for rehabilitation. The Enhanced Paper Grip Test (EPGT) is a simple method to measure this force.</p><p><strong>Objective: </strong>This cross-sectional observational study aimed to determine the reliability and validity of the EPGT in individuals post-stroke.</p><p><strong>Methods: </strong>Forty-four patients with ischemic stroke, aged 18 to 65 years (mean time since stroke 11.94 ± 6.31 months), participated in this study. The EPGT was applied in two sessions one week apart by two physiotherapists. Intra-rater and inter-rater reliability were calculated using intraclass correlation coefficients [ICC (3,1)]. Convergent validity was assessed by correlating EPGT scores with the modified mini-BESTest and ankle muscle strength measurements.</p><p><strong>Results: </strong>The EPGT demonstrated excellent intra-rater reliability (ICC = 0.927-0.990) and inter-rater reliability (ICC = 0.953-0.992). EPGT scores were strongly correlated with the modified mini-BESTest scores, with higher correlations on the affected side (ρ = 0.927, p < 0.001) than the non-affected side (ρ = 0.639, p < 0.001). Significant positive correlations were also observed between EPGT scores and ankle muscle strength, particularly on the affected side (ankle plantar flexors: ρ = ;0.826, p < 0.001; ankle dorsiflexors: ρ = 0.846, p < 0.001), while moderate-to-weak correlations were found on the non-affected side (APF: ρ = 0.435, p = 0.01; ADF: ρ = 0.353, p = 0.04).</p><p><strong>Conclusion: </strong>The EPGT is a valid and reliable tool for assessing hallux (big toe) pulling force post-stroke and can be quickly applied in clinical settings.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov (NCT07181005).</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"502-513"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147575484","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":"Respiratory and functional status of inpatients with stroke: a cross-sectional study.","authors":"Steve Freitas, Corália Pinto, Joana Magano, Miguel P Almeida","doi":"10.1080/10749357.2025.2579912","DOIUrl":"10.1080/10749357.2025.2579912","url":null,"abstract":"<p><strong>Background: </strong>Respiratory function and functional status are often impaired after stroke, yet respiratory assessment before rehabilitation is frequently overlooked. Few studies explore these parameters in the acute and subacute phases, which are critical for recovery. Understandingtheir relationship may guide more effective rehabilitation.</p><p><strong>Objectives: </strong>To characterize respiratory function and functional status in stroke inpatients at rehabilitation admission. Secondary objectives were to examine correlations between them, and to assess the influence of sex, age, comorbidities, body mass index, stroke type, and time since stroke on these correlations.</p><p><strong>Methods: </strong>A cross-sectional study included stroke inpatients admitted to rehabilitation between 2023 and 2024. Demographics, Maximal Inspiratory Pressure (MIP), Maximal Expiratory Pressure (MEP), Peak Cough Flow (PCF), Trunk Impairment Scale (TIS), and Functional Independence Measure (FIM) were collected.</p><p><strong>Results: </strong>Eighty-four participants (67% male; 49% aged 60-69; 48% > 25 kg/m²; 70% ischemic stroke; 38 median days post-stroke) were included. Respiratory function was: MIP (median: 48.5 cmH₂O; interquartile range [IQR]: 28.5;66), MEP (mean: 65.1 cmH₂O; standard deviation [SD]: 26.1) and PCF (mean: 218.5 L/min; SD: 142.1), which were majorly below reference values, except for PCF. Functional status was as follows: FIM (median: 84; IQR: 70.75;93) and TIS (median: 14; IQR: 10.75;18). Correlation analysis showed weak correlation between PCF and FIM (<i>R</i> = 0.35) and TIS (<i>R</i> = 0.30), and moderate correlations between FIM and MIP (<i>R</i> = 0.47) and MEP (<i>R</i> = 0.42). Demographics and stroke subtypes did not significantly impact these correlations.</p><p><strong>Conclusions: </strong>Respiratory and functional impairments are common early after stroke. Their significant correlation supports routine respiratory assessment at rehabilitation admission to guide individualized interventions, regardless of demographics or stroke subtypes.</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"533-541"},"PeriodicalIF":2.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145393340","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":"Chronic pain prevalence and severity associated with stroke survivorship.","authors":"Sylvia Wang, Em Long-Mills, Dmitry Tumin, Nurose Karim","doi":"10.1080/10749357.2025.2579911","DOIUrl":"10.1080/10749357.2025.2579911","url":null,"abstract":"<p><strong>Background: </strong>Chronic pain is a common complication following stroke. However, most studies assessing its prevalence among stroke survivors include relatively small samples and lack include comparator groups from the general population.</p><p><strong>Aims: </strong>This cross-sectional study compares prevalence and severity of chronic pain according to history of stroke survivorship by utilizing a large, nationally representative sample of United States adults.</p><p><strong>Methods: </strong>We analyzed data from adult respondents to the 2019, 2020, 2021, and 2023 National Health Interview Surveys (NHIS). Stroke survivorship was identified based on respondent self-report, and chronic pain was identified as experiencing pain most or every day for the past 3 months. Secondary outcomes included pain severity and pain impact on life, work, and family.</p><p><strong>Results: </strong>Among 105,179 survey responses, 3.6% reported a history of stroke. Nearly half of these respondents (48%, 95% confidence interval [CI]: 0.45, 0.50) reported chronic pain, in contrast to only 21% (95% CI: 0.21, 0.22) of respondents without a stroke history. Stroke respondents were more likely to suffer from chronic pain (odds ratio [OR]: 1.46, 95% CI: 1.32, 1.62), report higher pain severity (OR: 1.40, 95% CI: 1.28, 1.53), and higher impact pain (OR: 1.77, 95% CI: 1.59, 2.00) compared to those without a history of stroke.</p><p><strong>Conclusions: </strong>Future research on stroke and chronic pain should explore the mechanisms of chronic pain development to establish more targeted therapeutic interventions. Additionally, the association of stroke and chronic pain indicates that treatment should involve collaboration with multidisciplinary teams to promote early rehabilitation to reduce pain and disability.</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"576-584"},"PeriodicalIF":2.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145410182","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":"Correction.","authors":"","doi":"10.1080/10749357.2025.2565086","DOIUrl":"https://doi.org/10.1080/10749357.2025.2565086","url":null,"abstract":"","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":"33 5","pages":"595-596"},"PeriodicalIF":2.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148253172","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":"Multidimensional sleep health is associated with affective instability in community-dwelling survivors of stroke: an ecological momentary assessment study.","authors":"Stephen C L Lau, Daniel J Buysse, Allison G Harvey, Kui Kai Lau, Jack Jiaqi Zhang, Patrick Wai-Hang Kwong, Chun Liang Hsu, Tiev Miller, Eric C Landsness","doi":"10.1080/10749357.2025.2602148","DOIUrl":"10.1080/10749357.2025.2602148","url":null,"abstract":"<p><strong>Background: </strong>Affective instability is a form of emotion dysregulation and a known precursor to affective disorders. Sleep plays a critical role in emotional regulation. Survivors of stroke frequently experience disrupted sleep that contributes to affective disturbances, but the specific dimensions of sleep health associated with affective instability remain unclear.</p><p><strong>Objective: </strong>To examine the associations between dimensions of sleep health and affective instability in survivors of stroke.</p><p><strong>Methods: </strong>A secondary analysis of a 7-day prospective study involving 40 community-dwelling survivors of stroke who completed daily sleep diaries and eight daily ecological momentary assessments (EMA). Affective instability was assessed with EMA and quantified using mean squared successive difference (MSSD) and probability of acute change (PAC). Six dimensions of sleep health were assessed via EMA, sleep diaries, and the Pittsburgh Sleep Quality Index. Multivariable linear regression analyses were conducted to examine associations of sleep health with affective instability.</p><p><strong>Results: </strong>Higher mental fatigue (MSSD: β = .55, <i>p</i> = .001; PAC: β = .76, <i>p</i> < .001), lower sleep efficiency (PAC: β = -.35, <i>p</i> = .036), and longer sleep latency (PAC: β = .38, <i>p</i> = .030) were associated with greater depressed affect instability. More irregular mid-sleep timing (MSSD: β = .57, <i>p</i> < .001; PAC: β = .48, <i>p</i> = .004), more irregular sleep duration (MSSD: β = .43, <i>p</i> = .012), later sleep timing (MSSD: β = .51, <i>p</i> = .002), and longer sleep latency (MSSD: β = .39, <i>p</i> = .020; PAC: β = .39, <i>p</i> = .021) were associated with greater cheerful affect instability.</p><p><strong>Conclusions: </strong>Poorer sleep efficiency, higher mental fatigue, later sleep timing, and more irregular sleep patterns were associated with greater affective instability. Designing behavioral therapies targeting these sleep health dimensions may reduce affective instability and prevent post-stroke affective disorders.</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"585-594"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145715915","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":"Translation and cross-cultural adaptation of the Sedentary Behavior Questionnaire (SBQ) for stroke survivors.","authors":"Ana H Salles Dos Reis, Ana L Miranda de Oliveira, Camila Torriani-Pasin, Iza Faria-Fortini, Amanda Aparecida Oliveira Leopoldino, Janaine Cunha Polese","doi":"10.1080/10749357.2025.2572475","DOIUrl":"10.1080/10749357.2025.2572475","url":null,"abstract":"<p><strong>Background: </strong>Individuals frequently report adopting a sedentary lifestyle following a stroke. The Sedentary Behavior Questionnaire (SBQ) was developed to quantify daily time spent in specific sedentary behaviors (SB), and its translation will facilitate the identification of SB in Brazilian stroke survivors.</p><p><strong>Objective: </strong>Translate and cross-culturally adapt the SBQ questionnaire into Brazilian-Portuguese for use in stroke survivors.</p><p><strong>Methods: </strong>This is a methodological study for the translation and cross-cultural adaptation of the questionnaire. The nine SBQ items were translated in six steps, according Beaton <i>et al</i>: initial translation of the questionnaire, synthesis of translations, back-translation, synthesis of back-translations, committee of experts and testing of the pre-final (with 33 stroke survivors).</p><p><strong>Results: </strong>No discrepancies were observed between the original and back-translated versions, demonstrating adequate semantic and conceptual equivalence. The expert committee (10 physiotherapists) adapted the item descriptions to the grammatical rules of the Portuguese language and added examples to the item descriptions to increase comprehension. Participants included for final testing presented an average of 7.4 hours of SB per day, corresponding to 30.8% of the day. While on weekends this average was 6.9 hours per day, being approximately 28.75% of the day. There was an average of 37.04 total hours of SB during the week and 13.81 total hours of SB on weekends.  .</p><p><strong>Conclusion: </strong>The SBQ-Brazil was adequately translated and cross-culturally adapted into Brazilian-Portuguese, allowing its use in stroke survivors. Further research is required to validate the psychometric properties, such as reliability, and to support its broader application across diverse clinical populations in Brazil.</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"475-487"},"PeriodicalIF":2.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309430","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":"Peak cough flow and diaphragmatic excursion during coughing in stroke patients with tracheostomy: a cross-sectional study.","authors":"Dan Li, Pengfei Yao, Juan Wang, Yulong Wang","doi":"10.1080/10749357.2025.2597801","DOIUrl":"10.1080/10749357.2025.2597801","url":null,"abstract":"<p><strong>Background: </strong>Although peak cough flow (PCF) is a critical indicator for tracheostomized stroke patients, it remains unclear whether diaphragmatic excursion during reflex cough, as the primary driver of inspiration, can predict PCF.</p><p><strong>Objective: </strong>To explore whether the diaphragmatic excursion during reflex coughing can predict PCF in stroke patients with tracheostomy.</p><p><strong>Methods: </strong>A total of 57 stroke patients were included in the study. The diaphragm excursion and PCF were measured and a simple linear regression was used to analyze the relationship between them. T-test, Chi-square test and Mann-Whitney U test were used to analyze the influencing factors of PCF, and multiple linear regression was used to construct a regression model.</p><p><strong>Results: </strong>A simple regression model showed significant associations between diaphragmatic excursion and PCF in patients with unilateral and bilateral paralysis (<i>p</i> = 0.036, <i>R</i> = 0.372, R² = 0.139 for patients with unilateral paralysis; <i>p</i> = 0.002, <i>R</i> = 0.592, R² = 0.350 for patients with bilateral paralysis). Except for the diaphragmatic excursion, the type of paresis was also an influencing factor for PCF. A multiple regression model adjusted for type of paresis showed a significant association between PCF and diaphragmatic excursion (<i>p</i> < 0.001, adjusted regression coefficient = 7.883, adjusted R² = 0.257).</p><p><strong>Conclusions: </strong>Diaphragmatic excursion during coughing was correlated with PCF. Furthermore, the type of paresis in stroke patients was identified as a significant factor affecting PCF. Our study established the preliminary diaphragmatic excursion-adjusted type of paresis equation as a predictor for estimating PCF in patients with stroke who underwent tracheostomy.</p><p><strong>Trial registration numbers: </strong>ChiCTR2200063174.</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"542-548"},"PeriodicalIF":2.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145655708","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":"Associations of neuropathic pain and pain catastrophizing with rehabilitation outcomes in patients with stroke.","authors":"Ayse Esma Yildiz, Tugba Alisik","doi":"10.1080/10749357.2026.2691109","DOIUrl":"https://doi.org/10.1080/10749357.2026.2691109","url":null,"abstract":"<p><strong>Background: </strong>Neuropathic pain and pain catastrophizing are common after stroke and may be associated with poorer rehabilitation outcomes. However, their independent associations with functional recovery remain insufficiently explored.</p><p><strong>Objectives: </strong>This study aimed to determine the frequency of neuropathic pain and pain catastrophizing in patients with stroke and to examine their associations with post-treatment rehabilitation outcomes.</p><p><strong>Methods: </strong>In this prospective observational study, patients with post-stroke hemiplegia undergoing inpatient rehabilitation were evaluated at baseline and after a 4-week rehabilitation program. Functional status was assessed using the Barthel Index, Brunnstrom Staging, Modified Ashworth Scale, and Functional Ambulation Classification. Quality of life was assessed using the SF-12. Neuropathic pain and pain catastrophizing were assessed using the painDETECT questionnaire and Pain Catastrophizing Scale. Baseline-adjusted linear regression models examined whether baseline painDETECT and Pain Catastrophizing Scale scores were independently associated with post-treatment outcomes.</p><p><strong>Results: </strong>Eighty patients were included. At baseline, 10 patients (12.5%) had possible neuropathic pain, 17 (21.3%) had definite neuropathic pain, and 15 (18.8%) had clinically significant pain catastrophizing. After rehabilitation, possible and definite neuropathic pain were observed in 5 (6.3%) and 8 patients (10.0%), respectively, and clinically significant pain catastrophizing in 9 patients (11.3%). Functional and pain-related outcomes improved after rehabilitation. In adjusted models, higher baseline Pain Catastrophizing Scale scores were independently associated with lower post-treatment Barthel Index and Functional Ambulation Classification scores. Baseline painDETECT scores were not independently associated with post-treatment outcomes.</p><p><strong>Conclusions: </strong>Pain catastrophizing, but not painDETECT score, was independently associated with poorer post-treatment functional independence and ambulation.</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"1-11"},"PeriodicalIF":2.3,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148353691","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":"Education level amplifies the mediating pathway of rehabilitation motivation between metacognition and quality of life in stroke survivors.","authors":"Weitong Li, Yanhui Zhang, Chunsheng Yan, Yingchen Duan, Mei Sin Chong, Beilei Lin, Ling Ma, Zhenxiang Zhang, Suyan Chen, Yongxia Mei","doi":"10.1080/10749357.2026.2689579","DOIUrl":"https://doi.org/10.1080/10749357.2026.2689579","url":null,"abstract":"<p><strong>Background: </strong>Stroke is a leading cause of long-term disability globally, substantially impairing quality of life (QoL) in survivors. While maladaptive metacognitive beliefs is regarded as a potentially influential factor, the underlying mechanism through which it influences QoL remains unclear.</p><p><strong>Aims: </strong>To investigate QoL among stroke survivors, identify its influencing factors, and explore the mediating role of rehabilitation motivation between maladaptive metacognitive beliefs and QoL as well as the moderating role of education level.</p><p><strong>Methods: </strong>In this cross-sectional study, 772 convalescent stroke survivors were recruited from four Grade A tertiary hospitals in Henan Province, China, between October 2024 and August 2025. Data were collected using general characteristics questionnaire, the Metacognition Questionnaire, the Stroke Rehabilitation Motivation Scale, the Short-Version Stroke-Specific Quality of Life Scale, and the Barthel Index. Model 7 in process version 4.1 was used to test the moderated mediation model.</p><p><strong>Results: </strong>QoL was significantly correlated with occupation, residential status, stroke family history, stroke type, activities of daily living (ADL), metacognition, and rehabilitation motivation. The moderated mediation model involving rehabilitation motivation and education level for explaining how metacognition was associated with QoL was validated. Specifically, the mediating pathway through rehabilitation motivation was stronger among stroke survivors with higher education compared with those with lower education.</p><p><strong>Conclusion: </strong>Among stroke survivors, the association of metacognition with QoL is mediated by rehabilitation motivation, with this association being amplified by education level. For stroke survivors with varying education levels, interventions such as metacognitive therapy may improve metacognitive abilities, enhance rehabilitation motivation, and thereby promote QoL.</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"1-13"},"PeriodicalIF":2.3,"publicationDate":"2026-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148346370","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}