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Intersection of participation and environmental factors: a complex interactive process.

Luc Noreau1, Kathryn Boschen

  • 1Rehabilitation Department, Faculty of Medicine, Laval University, Quebec City, QC, Canada. Luc.Noreau@rea.ulaval.ca

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The environment significantly impacts participation in rehabilitation, particularly for spinal cord injury. However, current research struggles to scientifically demonstrate this environmental contribution to participation. Improved environmental measures are needed.

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Area of Science:

  • Rehabilitation Science
  • Environmental Psychology
  • Disability Studies

Background:

  • Historical literature suggests a strong "person-environment fit" concept influencing participation.
  • Contemporary research explores the link between participation and environmental factors in physical disability rehabilitation.
  • Environmental barriers and facilitators are critical for community integration.

Purpose of the Study:

  • To review historical and contemporary literature on environmental conceptualizations and measures in rehabilitation.
  • To examine the participation-environment association, with a focus on spinal cord injury.
  • To identify limitations in current research and suggest improvements for measuring environmental impact on participation.

Main Methods:

  • Systematic review of nonempirical literature (1935-present) and empirical rehabilitation articles (last 10 years).
  • Literature selection focused on physical disability rehabilitation, participation, and environmental influences.
  • Data extraction prioritized studies assessing both participation and environmental considerations.

Main Results:

  • Historical literature consistently indicates environmental impact on participation.
  • Recent empirical evidence shows environmental contributions to participation, but the effect size is small.
  • Scientific demonstration of the environment's role in participation restriction or facilitation remains limited.

Conclusions:

  • The theoretical impact of the environment on participation is acknowledged but not yet scientifically proven.
  • Enhancing participation-environment interaction requires refining environmental measures.
  • Future research should consider environmental measure comprehensiveness, participation dimensionality, and avoid environmental features in participation measure construction.