Oral Presentation Australian and New Zealand Stroke Organisation Conference 2025

Understanding Meaningful Participation After Stroke: A Qualitative Systematic Review   (121506)

Upendranatha Reddy Potturi 1 2 , Melanie Hoyle 1 , Sandra Brauer 3 , Bernadine Teng Sze Kee 4 , Suzanne Kuys 5 , Niruthikha Mahendran 1 6
  1. School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
  2. Rehabilitation Services, Woodlands Health Pte Ltd, Singapore
  3. Faculty of Health, Medicine and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, Australia
  4. Health and Social Sciences, Singapore Institute of Technology, Singapore
  5. School of Allied Health, Australian Catholic University, Brisbane, Queensland, Australia
  6. STARS Education and Research Alliance, Surgical Treatment and Rehabilitation Service (STARS), The University of Queensland and Metro North Health, Brisbane, Queensland, Australia

Background/Aims

Despite increasing emphasis on participation outcomes in stroke rehabilitation, currently, there is no accepted conceptualisation that captures the subjective, evolving nature of meaningful participation after stroke. This study aimed to understand what is meaningful participation from the perspective and experiences of adults with stroke.

Methods
Seven databases were searched from inception to October 2024. Studies were included if they involved community-dwelling adults with stroke and provided qualitative data on their perspectives and experiences of meaningful participation. Two reviewers independently reviewed all studies at screening and full-text stages. The methodological quality of the included studies was assessed using the McMaster Critical Review Form for Qualitative Studies. Relevant findings were extracted and analysed via inductive thematic synthesis. PROSPERO ID: CRD42023391062

Results
Fifty-six studies (n = 1,209 participants, aged 19–93 years, from 22 countries) were identified. Meaningful participation was described as a subjective and evolving concept, shaped by the ability to regain a sense of normalcy, achieve independence, and feel valued. Three overarching analytical themes emerged: (1) Regaining normality (descriptive themes a. Resuming pre-stroke activities, b. Finding a new purpose), (2) Achieving independence (descriptive themes a. performing everyday activities, b. control over decision making, c. doing one's share), and (3) Feeling valued (descriptive themes a. Fulfilling social roles b. maintaining relationships, c. rebuilding social connections). 

Conclusions
Meaningful participation after a stroke extends beyond physical recovery, encompassing identity, autonomy, and social belonging. Rehabilitation strategies should integrate person-centred approaches that address psychosocial and participation goals, fostering long-term well-being.