Biopsychosocial factors associated with the state of disability after hemiparesis in the chronic phase of stroke: exploratory analysis based on the International Classification of Functioning, Disability and Health

Abstract

Objective To identify the main biopsychosocial factors associated with disability level after stroke using the International Classification of Functioning, Disability and Health (ICF) model. Methods A cross-sectional study was conducted with chronic stroke survivors. Disability was assessed using the World Health Disability Assessment Schedule 2.0. The independent variables were: Body functions: emotional functioning and whether the dominant upper limb was affected. For the Activities & Participation component, satisfaction regarding the execution of activities and participation were assessed using the SATIS-Stroke, as well as the locomotion ability for adults (ABILOCO), manual ability (ABILHAND) and the return to work. For environmental factors, income and facilitators and obstacles were assessed using the Measure of the Quality of the Environment (MQE). Personal factors: age and sex. Multiple Linear Regression was employed. Results Limited locomotor ability (β = −0.281; t = −3.231 p = 0.002), dissatisfaction regarding activities and participation (β = −0.273; t = −3.070 p = 0.003), and the non-return to work (β = 0.162; t = 2.085 p = 0.04) were associated with disability. Conclusion The reduction in locomotor ability, dissatisfaction regarding activities and participation and the non-return to work were associated with disability in the chronic phase following a stroke. IMPLICATIONS FOR REHABILITATION The reduction in locomotion ability, dissatisfaction regarding activities and participation, and the non-return to work were associated with disability in the chronic phase following a stroke. Clinicians will be able to develop rehabilitation strategies focused on diminishing locomotor limitations, increasing satisfaction with activities and participation, and improving vocational planning for the return to work after a stroke These findings underscore the importance of assessments and intervention strategies based on the individual rather than the disease as well as focusing on social and personal issues to guide clinical decision making.