abstract: 'BACKGROUND: A large proportion of individuals with a stroke are unable

  to return to work, although figures vary greatly. Due to the very high

  cost of post-stroke care, both tangible and intangible, in the form of

  long-term social consequences, it seems extremely important to search

  for factors responsible for the low efficiency of the rehabilitation and

  recovery process, because this fact has direct influence on future

  employment. Such knowledge would enable physiotherapists to quickly

  identify those patients who are at risk of rehabilitation breakdown, in

  order to provide them with special care and include them in intensive

  therapeutic treatments.

  OBJECTIVE: The aim of the study was to assess the efficacy of

  post-stroke rehabilitation, evaluated within the biopsychosocial aspect.

  METHODS: The study consisted of 120 patients after first stroke,

  including 48 women and 72 men aged 58.0 (+/- 8.6). The measure of the

  effects of physiotherapy in the present study was not only the

  improvement of the functional state (simple and complex activities of

  daily life, locomotive activities), but also the improvement of the

  mental state (mood and the sense of well-being, level of acceptance of

  illness, perceived self-efficacy) and the reduction of pain. The

  Mini-Mental State Examination, the Geriatric Depression Scale, the

  Generalized Self-Efficacy Scale, the Acceptance of Illness Scale, the

  Visual Analogue Scale, the Barthel Index, the Instrumental Activity of

  Daily Living and the Rivermead Mobility Index were used. All parameters

  were measured twice: on admission to the ward and after three weeks of

  physiotherapy. The characteristics of the study group were presented

  using descriptive statistics. The analysis of interdependence of the

  efficacy of physiotherapy used two non-parametric tests: the

  Mann-Whitney U test to compare two groups, and the Kruskal-Wallis ANOVA

  test to compare a greater number of groups. Correlations between

  characteristics with continuous distributions were assessed using

  Spearman''s rank correlation coefficient (rho), and in case of

  categorical variables, Pearson''s chi-squared (chi(2)) correlation

  coefficient. Linear regression was used to determine the hierarchy of

  the influence of particular characteristics on the efficacy of

  physiotherapy.

  RESULTS: Statistical analyzes show that patient''s age, time since

  stroke, number of comorbidities, family care capacity, marital status of

  the patient and also a low level of acceptance of illness, depression

  symptoms and lack of a sense of self-efficacy were related with low

  efficacy of post-stroke rehabilitation

  CONCLUSIONS: Comprehensive neurological rehabilitation, taking into

  account mental challenges and socio-economic circumstances of

  individuals with a stroke is essential in order to achieve high efficacy

  of physiotherapy. Important external factors may play a pivotal role in

  returning to work as well and should be taken into account during

  rehabilitation. Of interest should be to assess more biopsychological

  factors, such as acceptance of illness and a sense of self-efficacy

  referred to as barriers to return to work.'
affiliation: 'Mazurek, J (Corresponding Author), Dept \& Div Med Rehabil, Ul Borowska
  213, Wroclaw, Poland.

  Neustein, Jolanta; Wojcik, Bartosz; Belza, Malgorzata; Cichosz, Michal, Wroclaw
  Ctr Rehabil \& Sports Med, Dept Neurol Rehabil, Wroclaw, Poland.

  Kobylanska, Marzena; Kowalska, Joanna; Szczepanska-Gieracha, Joanna, Univ Sch Phys
  Educ, Dept Physiotherapy, Wroclaw, Poland.

  Mazurek, Justyna, Wroclaw Med Univ, Dept \& Div Med Rehabil, Wroclaw, Poland.'
author: Kobylanska, Marzena and Kowalska, Joanna and Neustein, Jolanta and Mazurek,
  Justyna and Wojcik, Bartosz and Belza, Malgorzata and Cichosz, Michal and Szczepanska-Gieracha,
  Joanna
author-email: justyna\_mazurek@poczta.onet.pl
author_list:
- family: Kobylanska
  given: Marzena
- family: Kowalska
  given: Joanna
- family: Neustein
  given: Jolanta
- family: Mazurek
  given: Justyna
- family: Wojcik
  given: Bartosz
- family: Belza
  given: Malgorzata
- family: Cichosz
  given: Michal
- family: Szczepanska-Gieracha
  given: Joanna
da: '2023-09-28'
doi: 10.3233/WOR-162823
eissn: 1875-9270
files: []
issn: 1051-9815
journal: WORK-A JOURNAL OF PREVENTION ASSESSMENT \& REHABILITATION
keywords: 'Post-stroke rehabilitation; physiotherapy; occupational therapy;

  neurological rehabilitation; depression symptoms; return to work;

  younger adults; intervention; clinical practice'
keywords-plus: 'LENGTH-OF-STAY; DISCHARGE DESTINATION; POSTSTROKE DEPRESSION;

  PROGNOSTIC-FACTORS; WORK; RETURN; EXPERIENCES; YOUNG; OUTCOMES; ADULTS'
language: English
number: '4'
number-of-cited-references: '56'
orcid-numbers: 'Mazurek, Justyna/0000-0001-8983-0286

  Kowalska, Joanna/0000-0002-5232-1688

  Szczepanska-Gieracha, Joanna/0000-0001-5191-3799'
pages: 523-535
papis_id: 77a20caf0a6a5171256046cfe7a033c9
ref: Kobylanska2018rolebiopsychosocial
researcherid-numbers: 'Mazurek, Justyna/AAX-9871-2020

  Kowalska, Joanna/ABC-5637-2021

  '
times-cited: '26'
title: The role of biopsychosocial factors in the rehabilitation process of individuals
  with a stroke
type: Article
unique-id: WOS:000455262400005
usage-count-last-180-days: '1'
usage-count-since-2013: '15'
volume: '61'
web-of-science-categories: Public, Environmental \& Occupational Health
year: '2018'