Bridging the gap: Essential factors for poststroke community reintegration in low-and-middle income countries

Community reintegration (CR), a fundamental goal in stroke rehabilitation, depends on both patients' personal factors and disease-related factors. Dissatisfaction in reintegration levels is commonly observed among chronic stroke patients; hence, it is essential to understand the factors influencing CR of the chronic stroke patients in low-and-middle income countries.

A cross-sectional study was carried out involving 53 chronic stroke patients residing in the community aged over 18 years, with a single episode of stroke. Demographic details and patient-reported outcomes, including community reintegration, perceived social participation, balance self-efficacy, fear of fall, physical function, quality of life, caregiver strain, and perceived social support, were collected. The outcomes were correlated using Karl Pearson's correlation for continuous and the t-test for categorical variables. Furthermore, a multiple linear regression was employed to identify the strongest predictor.

All the patient-reported outcomes assessed in the present study have a significant influence on CR. A multiple regression analysis revealed that perceived social participation (β = -4.039, p < 0.001), physical function (β = 0.470, p = 0.018), and caregiver strain (β = -0.241, p = 0.040) were good predictors of CR. However, perceived social participation restriction was observed to be the strongest predictor (R2 = 0.812).

This study identified balance self-efficacy, physical function, quality of life, and perceived social support as positive contributors to CR, while fear of fall, caregiver strain and reduced perceived social participation hindered CR. Findings highlight the need for culturally sensitive strategies, especially in lowmiddle income countries, where family-led caregiving is predominant. Community-based programs and inclusive digital platforms may enhance recovery while empowering both patients and caregivers.